Tobramycinum

Tobramycinum – a bactericidal antibiotic from group of aminoglycosides.

Pharmacological action

Tobramycinum bakteritsidno affects microorganisms. It breaks their life activity, blocking one of subunits of ribosomes, so, breaks synthesis of protein in a microorganism. If to use it in the most admissible dosages, then drug can damage cytoplasmic membranes of bacteria.

Tobramycinum according to the instruction has a broad spectrum of activity, perniciously affecting the gram-positive and gram-negative bacteria sensitive to it. It is especially effective concerning various stafilokokk (including, steady against penicillinic antibiotics), a tsitrobakter, some types of streptococci, intestinal, hemophilic and pyocyanic sticks, a klebsiyella, an enterobakter, a protea, moraksella, an acinetobacter, some neysseriya.

Researches showed that Tobramycinum is capable to oppress life activity even those bacteria which are steady against effect of other aminoglycoside – gentamycin.

Tobramycinum pharmacokinetics is well studied. It is badly soaked up at intake. At introduction to a muscle drug quickly comes to a circulatory bed, reaching the maximum concentration in 0,5 – 1,5 hours. It almost does not contact proteins of plasma. Well passes through a placenta, but practically does not get through a blood-brain barrier into a brain.

The antibiotic well gets into liquid of an abdominal cavity, joints and into a phlegm. Persons with disturbances of renal filtering and at newborn children have a maintenance of Tobramycinum in blood more and remains longer on time.

Removal of drug from an organism is made in an invariable look by kidneys.

Form of release of Tobramycinum

Drug is produced in the form of powder for preparation of solution for injections, and also Tobramycinum solution in ampoules.

Indications to use of Tobramycinum

Tobramycinum is used for treatment of the infections caused by microorganisms, sensitive to it, including – infections of bones (osteomyelitis), joints (arthritises), biliary tract, the central nervous system (meningitis), a respiratory organs (pneumonia, lung abscess, an empyema), an abdominal cavity (peritonitis), soft tissues and skin, urinary tract (cystitis, pyelonephritis), sepsis.

Because of ability to oppress effectively life activity of a pyocyanic stick solution of Tobramycinum is applied to inhalations at patients with a mucoviscidosis, since 6 years at which this microorganism often parasitizes in respiratory tracts.

The antibiotic found topical administration in ophthalmology at bacterial diseases of eyes and appendages of an eye (conjunctivitis, a keratitis, a blepharitis, etc.).

Contraindications

As well as other aminoglycosides, Tobramycinum ототоксичен and нефротоксичен therefore it is not applied at a heavy renal failure, and also at a hearing disorder. Also Tobramycinum according to the instruction is contraindicated at hypersensitivity of an organism to aminoglikozidny antibiotics.

During pregnancy and breastfeeding in the decision on use of this antibiotic the ratio risk/advantage has to be weighed. Tobramycinum is allowed for use since the birth.

With care and in minimum effective dosage use drug at botulism, a myasthenia, dehydration, a renal failure, at elderly.

Application instruction of Tobramycinum

The antibiotic can be entered intravenously, intramusculary, locally and it is inhalation. To prepare solution for intramuscular introduction, powder in a bottle it is necessary to dissolve 0,5% of novocaine in 3 – 5 ml. For intravenous administration it is dissolved in 100 – 200 ml 0,9% of solution of sodium chloride or 5% of solution of glucose. The dose is calculated on kilogram of weight. For newborn children it makes 2 – 4 mg/kg/days in 2 introductions, 5 mg/kg/days are most admissible. From 2 months to 1 year Tobramycinum is calculated on 6 – 7,5 mg/kg/days in 3 – 4 introductions. For children 1 years and adult – 3 mg/kg/days in 3 – 4 introductions are more senior. The course of treatment is individual, is defined by the nature of a disease and its weight. It averages 5 – 10 days, but can be prolonged up to 3 – 6 weeks. For patients with diseases of kidneys the dosage is reduced and increase intervals between introductions.

At inflammatory diseases of eyes Tobramycinum is applied locally, by instillations on 1 – 2 drops each 4 hours. At a mucoviscidosis solution of Tobramycinum is added to the nebulizer, and each 8 hours breathe them.

During treatment it is necessary to control functions of kidneys, a liver and hearing.

Side effects

Tobramycinum according to the instruction has many undesirable effects – allergic reactions, nausea, vomiting, diarrhea, disturbances in system of blood, change of biochemical composition of blood, an irreversible hearing disorder, a headache, drowsiness, disturbances of sensitivity, a spasm, disturbance of work of kidneys, candidiasis and ulcers of a mouth.