Tobramycin Ophthalmic Dosage

Medically reviewed by Drugs.com. Last updated on Dec 24, 2024.

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.

See also:

Further information

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

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