Indication

Ocular infection, bacterial eye infection

Adult dose

Ophthalmic Ocular infections Adult: As eye drop: Mild to moderate infections: Instill 1-2 drops into affected eye every 4 hr. Severe infections: Instill 2 drops into affected eye every 30-60 minutes initially until improvement, reduce treatment frequency before discontinuation. As eye ointment: Mild to moderate infections: Apply a half-inch ribbon bid-tid into affected eye. Severe infections: Apply a half-inch ribbon into the affected eye every 3-4 hr until improvement, reduce treatment frequency before discontinuation.

Child dose

Ophthalmic Ocular infections Child: >1 yr: As eye drop: Mild to moderate infections: Instill 1-2 drops into affected eye every 4 hr. Severe infections: Instill 2 drops into affected eye every 30-60 minutes initially until improvement, reduce treatment frequency before discontinuation. As eye ointment: Mild to moderate infections: Apply a half-inch ribbon bid-tid into affected eye. Severe infections: Apply a half-inch ribbon into the affected eye every 3-4 hr until improvement, reduce treatment frequency before discontinuation.

Contraindication

This eye drop is contraindicated in epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella and other viral disease of the cornea and conjunctiva.It is contraindicated in mycobacterial infections of the eye caused by acid-fast bacilli such as Mycobacterium tuberculosis, Mycobacterium leprae, or Mycobacterium avium. Fungal diseases of eye, untreated purulent infection of the eye. Hypersensitivity to any component of the medication.

Mode of action

Tobramycin acts by binding to 30S ribosomal subunits thus interfering with bacterial protein synthesis. It is active against many aerobic gram-negative bacteria and some aerobic gram-positive bacteria but inactive against Chlamydia, fungi, viruses, and most anaerobic bacteria.

Precaution

May result in overgrowth of nonsusceptible organisms, including fungi. Patient Counselling This drug may cause temporary blurred vision, if affected, do not drive or operate machinery. Contact lens wear is not recommended during treatment Lactation: Unknown whether drug is safe for nursing infants; discontinue, or do not nurse

Side effect

Localized ocular toxicity and hypersensitivity, including increased lacrimation, itching and edema of eyelid, and conjunctival erythema (<3%) Sensitivity reaction, punctate keratitis

Interaction

Increased nephrotoxicity or ototoxicity with etacrynic acid, furosemide, other aminoglycosides, cefalotin, cisplatin, vancomycin, piperacillin, ciclosporin, amphotericin B. Decrease serum tobramycin levels with miconazole. Potentially Fatal: Increased neuromuscular-blocking activity with magnesium and other neuromuscular-blocking agents.