![]() įor severe infections, the dosage for tobramycin is 3 mg/kg/d in divided doses every 8 hours. Intramuscular injection, intravenous infusion, and intraventricular (off-label) administration have been used to treat serious bacterial infections. Metabolism: The uptake of tobramycin into hepatocytes is limited, and the drug is minimally metabolized in the liver.Įxcretion: Tobramycin is excreted primarily by glomerular filtration. The elimination half-life of tobramycin following parenteral administration is 2 to 3 hours and varies from 50 to 70 hours in patients with impaired renal function. Inhaled tobramycin produces bactericidal concentrations in the lower respiratory tract in children with cystic fibrosis. Concentrations in the kidney are higher than in the serum. Tobramycin is distributed in sputum, synovial, and peritoneal fluids. Tobramycin is present in CSF, and concentrations depend on the dose and extent of meningeal inflammation. ĭistribution: Concentrations in bile and stools are low, indicating minimum biliary excretion. Tobramycin is excreted via the kidneys through glomerular filtration. The serum half-life of tobramycin is about 2 hours in an adult and prolonged in neonates to about 4.5 to 8.7 hours. When tobramycin is administered via intravenous infusion over one hour, it achieves similar serum concentrations compared to intramuscular administration. Tobramycin is poorly absorbed from the gastrointestinal tract. Therapeutic levels of tobramycin are generally considered to be between 4 to 6 mcg/mL. Tobramycin dose of 1 mg/kg of body weight results in 4 mcg/mL peak serum concentrations. Peak serum concentrations of tobramycin are achieved in 30 to 90 minutes following intramuscular administration. Ībsorption: Tobramycin is absorbed rapidly following intramuscular injection. Incorrectly synthesized proteins build up inside the cell, disrupting the cell membrane and various cellular processes this mechanism of action designates tobramycin as a bactericidal agent. By binding to the A-site, tobramycin induces mistranslation and causes transfer RNA to misread the codon, thus causing incorrect delivery of aminoacyl units. Tobramycin binds to the 16s ribosomal RNA component of the bacterial 30s ribosomal unit, inhibiting the initiation step of translation. According to guidelines from the American Academy of Allergy, Asthma, and Immunology, tobramycin can be used for prophylaxis of bacterial respiratory tract infection in patients with primary immunodeficiency diseases. Off-label use of tobramycin includes intraventricular administration in managing intraventricular catheter-associated central nervous system infections. ![]() ![]() Tobramycin for ophthalmic use is FDA-approved to treat external ocular infections caused by susceptible organisms in adults and children. CF guidelines recommend the chronic use of inhaled tobramycin in patients with CF to improve lung function, reduce exacerbations, and improve quality of life in patients with CF. Inhaled tobramycin is FDA-approved to manage cystic fibrosis (CF) in patients aged six or older with Pseudomonas aeruginosa. ![]() Infections caused by organisms susceptible to tobramycin can vary in nature and include septicemia, lower respiratory tract infections, central nervous system (CNS) infections like meningitis, intra-abdominal infections, skin and subcutaneous tissue infections, osteomyelitis, and complicated urinary tract infections. Gram-negative bacteria include Pseudomonas aeruginosa, Escherichia coli, and species of Proteus, Klebsiella, Enterobacter, Serratia, Providencia, and Citrobacter. The FDA has approved systemic administration (intramuscular or intravenous) of tobramycin to treat various reinfections caused by susceptible organisms, mainly gram-negative bacteria and Staphylococcus aureus (penicillinase and non penicillinase-producing strains). Tobramycin has been prescribed to treat superficial infections and deep infections. Aminoglycosides are then actively transported across the bacterial cell membrane to bind and inactivate the initiation complex of translation. These drugs work synergistically with beta-lactams to penetrate the cell walls of aerobic gram-negative bacteria. The majority of antibiotics in this class, including tobramycin, are bactericidal. Streptomycin, the first aminoglycoside, was first isolated from Streptomyces griseus and introduced into clinical use in 1944 this led to the successful development of others in its category. Tobramycin belongs to the class of broad-spectrum antibiotics known as aminoglycosides.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |