Tobramycin Ophthalmic Dosage

Medically reviewed by Drugs.com. Last updated on Dec 26, 2022.

Usual Adult Dose for Bacterial Conjunctivitis

Ophthalmic ointment:

• Mild to moderate disease: Apply a 1.27 cm long ribbon to the affected eye(s) 2 to 3 times a day
• Severe disease: Apply a 1.27 cm long ribbon to the affected eye(s) every 3 to 4 hours until improvement, increasing the dosing interval gradually until discontinuation

Ophthalmic solution:

• Mild to moderate disease: 1 to 2 drops into the affected eye(s) every 4 hours
• Severe disease: Up to 2 drops into the affected eye(s) every hour until improvement, increasing the dosing interval gradually until discontinuation

Comments:

• The tip of the container should not be allowed to touch any surface, including the eye or eyelid.
• This drug should not be injected or directly introduced into the anterior chamber of the eye.

Use: Treatment of external infections of the eye and its adnexa caused by susceptible strains of:

• Acinetobacter calcoaceticus
• Enterobacter aerogenes
• Escherichia coli
• Haemophilus aegyptius
• Haemophilus influenzae
• Klebsiella pneumoniae
• Moraxella lacunata
• Morganella morganii
• Some Neisseria species
• Proteus mirabilis
• Most Proteus vulgaris strains
• Pseudomonas aeruginosa
• Staphylococci (including Staphylococcus aureus, coagulase-positive/-negative Staphylococcus epidermidis, and penicillin-resistant strains)
• Streptococci (including some group A beta-hemolytic species, and some Streptococcus pneumoniae)

Usual Pediatric Dose for Bacterial Conjunctivitis

2 months and older:
Ophthalmic ointment:

• Mild to moderate disease: Apply a 1.27 cm long ribbon to the affected eye(s) 2 to 3 times a day
• Severe disease: Apply a 1.27 cm long ribbon to the affected eye(s) every 3 to 4 hours until improvement, increasing the dosing interval gradually until discontinuation

Ophthalmic solution:

• Mild to moderate disease: 1 to 2 drops into the affected eye(s) every 4 hours
• Severe infections: Up to 2 drops into the affected eye(s) every hour until improvement, increasing the dosing interval gradually until discontinuation

Comments:

• The tip of the container should not be allowed to touch any surface, including the eye or eyelid.
• This drug should not be injected or directly introduced into the anterior chamber of the eye.

Use: Treatment of external infections of the eye and its adnexa caused by susceptible strains of:

• A calcoaceticus
• E aerogenes
• E coli
• H aegyptius
• H influenzae
• K pneumoniae
• M lacunata
• M morganii
• Some Neisseria species
• P mirabilis
• Most P vulgaris strains
• P aeruginosa
• Staphylococci (including S aureus, coagulase-positive/-negative S epidermidis, and penicillin-resistant strains)
• Streptococci (including some group A beta-hemolytic species, and some S pneumoniae)

Usual Pediatric Dose for Surgical Prophylaxis

American Academy of Pediatrics Recommendations: Multiple drops to the affected eye(s) 2 to 24 hours prior to the procedure

Comment: Susceptibility of isolates should be considered when determining treatment.

Use: Preoperative antimicrobial prophylaxis in neonatal patients older than 72 hours and children undergoing ophthalmic procedures with the following likely pathogens:

• Enteric gram-negative bacilli
• Pseudomonas species
• S aureus
• S epidermidis
• Streptococci

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Patients receiving topical and systemic aminoglycoside antibiotics: Total serum concentrations should be monitored.

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or to any of the ingredients

NARROW THERAPEUTIC INDEX:

• This drug should be considered a narrow therapeutic index (NTI) drug as small differences in dose or blood concentrations may lead to serious therapeutic failures or adverse drug reactions.

Recommendations:

• Generic substitution should be done cautiously, if at all, as current bioequivalence standards are generally insufficient for NTI drugs.
• Additional and/or more frequent monitoring should be done to ensure receipt of an effective dose while avoiding unnecessary toxicities.

Safety and efficacy have not been established in patients younger than 2 months.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• This drug should not be injected or introduced into the anterior chamber of the eye.
• During administration, the tip of the container should not touch the eye, eyelid, or any other surface.
• Ophthalmic ointment: Prior to administration, the manufacturer product information should be consulted.

Storage requirements:

• Ophthalmic ointment: Store at 2 to 25C
• Ophthalmic solution: Store at or below 25C; keep container tightly closed when not in use.

General:

• Limitation of use: This drug is not effective against most strains of group D Streptococci.

Monitoring:

• HYPERSENSITIVITY: Signs/symptoms of hypersensitivity
• IMMUNOLOGIC: Bacterial response to treatment

Patient advice:

• Inform patients that this drug may cause blurred vision, and they should avoid driving or operating machinery if these side effects occur.
• Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer