Bacide

Indications

• Eye drops or ointment: bacterial eye infections such as conjunctivitis, inflamed eyelids (blepharitis) and some corneal infections
• Injection (in hospital): serious bacterial infections, especially those caused by Pseudomonas, such as blood, lung, urinary, abdominal, bone and skin infections
• Inhalation: long-term lung infection with Pseudomonas in people with cystic fibrosis, under specialist care

How It Works

Tobramycin is an aminoglycoside antibiotic. It attaches to the part of the bacterial cell that makes proteins (the ribosome), so the bacteria make faulty proteins and die.

Dosage and Administration

• Eye drops, mild to moderate infection: usually 1 or 2 drops into the affected eye every 4 hours. Severe infection: 2 drops every hour at first, then less often as it improves, as advised.
• Eye ointment: about 1 cm ribbon inside the lower eyelid two or three times a day, as advised.
• Injection: given by a doctor or nurse; the dose depends on weight and kidney function, and blood levels are checked, as prescribed.
• Inhalation: as prescribed.

Wash hands before use and do not let the dropper tip touch the eye. Use for the full time advised, usually about 7 days for the eye.

Interactions

• Injection and inhalation: other medicines that can harm the kidneys or hearing, such as Furosemide, Vancomycin, Amphotericin B, Cisplatin and Ciclosporin, increase the risk of damage.
• Eye drops: if using other eye drops, leave at least 5 minutes between them.

Contraindications

• Allergy to tobramycin or other aminoglycoside antibiotics such as Gentamicin or Amikacin
• Myasthenia gravis, for the injection

Side Effects

Eye drops: brief stinging, itching, redness or watering, and eyelid swelling. Injection: can affect the kidneys and inner ear, causing hearing loss, ringing in the ears or dizziness. Inhalation: cough, voice change and tightness in the chest.

Get urgent medical help if there is swelling of the face, lips or throat, difficulty breathing or wheezing after inhaling, a severe rash, eye pain or worsening vision, new hearing loss or ringing in the ears, or passing much less urine.

Pregnancy and Lactation

Eye drops are absorbed very little and can be used in pregnancy and breastfeeding if the doctor advises. The injection can harm the unborn baby's hearing and kidneys and is used in pregnancy only when essential. Small amounts of the injected medicine pass into breast milk; the doctor will advise.

Precautions and Warnings

• Do not wear contact lenses during an eye infection or while using the drops.
• Do not use eye drops for longer than advised, as resistant germs or fungi may grow.
• See a doctor if the eye is not better in a few days.
• With the injection, kidney function, hearing and blood levels are monitored.

Overdose

Too many eye drops are unlikely to cause harm; rinse the eye with clean water. An injection overdose can damage the kidneys and hearing and is treated in hospital, where dialysis may be used.

Therapeutic Class

Aminoglycoside antibiotic.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze. Throw away eye drops 4 weeks after opening.