Tobramycin is a well-known antibiotic that is particularly effective and is used for the therapy of infectious diseases. However, because of its aggressiveness, tobramycin is never the first-line agent. It is only used when milder agents no longer achieve acceptable results.
What is tobramycin?
The medical drug tobramycin is one of the antibiotics. It is therefore able to kill certain disease-causing bacteria in a targeted and effective manner. It is also known as tobramycinum and, due to its specific properties, belongs to the group of aminoglycosides. This term is used to group together a number of antibiotics that are chemically similar. Tobramycin is indicated for the treatment of bacterial infectious diseases and is marketed under various trade names. In countries where it is licensed, tobramycin is generally subject to pharmacy and prescription requirements, so that it cannot be purchased completely independently, but requires a doctor’s prescription. In chemistry, tobramycin is described by the molecular formula C 18 – H 37 – N 5 – O 9 – Mr . This structure corresponds to a moral mass of approximately 467.51 g/mol. The most common forms of administration include creams, injections, and drops. In contrast, tobramycin is not used in film-coated tablets.
Pharmacologic effects on the body and organs
Because of its chemical and pharmacological properties, tobramycin belongs to the group of so-called aminoglycosides. This collective term covers a large number of heterogeneous antibiotics. Representatives of this group usually have at least two amino sugar molecules or sugar molecules that are linked to each other. This results in some common features with regard to the mechanism of action. Tobramycin leads to an inhibition of protein production. As a result of the antibiotic, the pathogenic bacteria are no longer able to produce proteins on their own, which ultimately leads to their death. The effect of tobramycin can therefore be described as bactericidal. Literature describes tobramycin as a comparatively aggressive substance. As such, the antibiotic may be particularly effective at killing bacteria, however, parts of its action have negative effects on the human body.
Medical use and use for treatment and prevention.
The medical application of tobramycin represents the killing of Gram-negative bacteria. Gram-negative bacteria are those that turn red when a differential staining procedure (Gram stain) is performed. This enables differentiation from Gram-positive pathogens, which turn blue. An indication exists for severe pneumonia as well as respiratory diseases that may have developed in the hospital. It can also be used to treat complicated urinary tract infections and infections of the abdomen, skin, muscles or tendons. In addition, severe burns represent an area of application for tobramycin. In children in particular, it is also used to treat cystic fibrosis. Eye drops containing tobramycin as the active ingredient are prescribed to treat tobramycin-susceptible bacteria of the outer eye or anterior eye area (e.g., inflammation of the eyelid, conjunctivitis, or inflammation of the cornea). However, because of its toxic effect in parts, tobramycin is never the first agent to be used as part of a therapy. Tobramycin is therefore considered ultima ratio. Tobramycin is not administered as a tablet, which is typical for representatives of the aminoglycoside group. This is a special feature, as the tablet form is the most common administration of antibiotics today, because it allows the patient to take the drug on his or her own. Tobramycin, on the other hand, is used in the form of injections, creams or ointments, and eye or ear drops for local application. Inhalations are also possible.
Risks and side effects
Even when taken or used correctly, tobramycin can cause risks and side effects. The most common adverse effects that may occur after use include an excess of immature blood cells and local irritation after an infusion is performed.Other side effects include increased ASAT and ALAT levels, low white blood cell count, headache, and gastrointestinal disorders (nausea, loss of appetite, vomiting). A skin rash, redness, or itching are also potentially conceivable side effects. Rare side effects include diarrhea, fever, calcium, potassium, magnesium, or sodium deficiency, and the development of massive skin reactions (e.g., Stevens-Johnson syndrome). Very rare are hives, general malaise, swelling of the lymph glands, drowsiness, and fungal infections. The likelihood of certain side effects occurring depends on the particular form of administration. The individual circumstances of each case must also be taken into account. Tobramycin must not be used if there is a known intolerance. This is because there is a contraindication in these cases. Extreme caution should be exercised in patients with kidney damage, as this may also be considered a contraindication. Furthermore, attention must be paid to interactions with other drugs. For example, they may occur if colistin, polymyxins or amphotericin B are taken at the same time. The physician must therefore always be kept informed of all medications taken.
