The Basics

What is Tobramycin?

Used to treat eye infections.

Brand names for Tobramycin

Kitabis Pak

How Tobramycin is classified

Anti-Infective Agents, Antibacterial Agents, Aminoglycosides

Tobramycin During Pregnancy

Tobramycin pregnancy category

Category Not AssignedNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Tobramycin while pregnant

Advise patients to talk with their physician if they want to become pregnant while on tobramycin inhalation solution because tobramycin inhalation solution is in a class of antibacterial drugs that have caused harm to the fetus .

Taking Tobramycin While Breastfeeding

What are recommendations for lactation if you're taking Tobramycin?

Tobramycin is poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of other aminoglycosides, but serum levels with typical three times per day dosages are far below those attained when treating newborn infections and systemic effects of tobramycin are unlikely. Older infants would be expected to absorb even less tobramycin. Because there is little variability in the milk tobramycin levels during multiple daily dose regimens, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Data are not available with single daily dose regimens. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (e.g., thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis. Maternal use of an ear drop or eye drop that contains tobramycin presents little or no risk for the nursing infant [4]

Maternal / infant drug levels

Tobramycin is poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of other aminoglycosides, but serum levels with typical three times per day dosages are far below those attained when treating newborn infections and systemic effects of tobramycin are unlikely. Older infants would be expected to absorb even less tobramycin. Because there is little variability in the milk tobramycin levels during multiple daily dose regimens, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Data are not available with single daily dose regimens. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (e.g., thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis. Maternal use of an ear drop or eye drop that contains tobramycin presents little or no risk for the nursing infant [4]

Possible effects of Tobramycin on milk supply

Relevant published information was not found as of the revision date.

Possible alternatives to Tobramycin

None listed

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Niebyl JR. Use of antibiotics for ear, nose, and throat disorders in pregnancy and lactation. Am J Otolaryngol. 1992;13:187-92. PMID: 1503194
2. Takase Z, Shirafuji H, Uchida M et al. Laboratory and clinical studies on tobramycin in the field of obstetrics and gynecology. Chemotherapy. (Tokyo). 1975;23:1402-7.
3. Uwaydah M, Bibi S, Salman S. Therapeutic efficacy of tobramycin–a clinical and laboratory evaluation. J Antimicrob Chemother. 1975;1:429-37. PMID: 1107297
4. Festini F, Ciuti R, Taccetti G et al. Breast-feeding in a woman with cystic fibrosis undergoing antibiotic intravenous treatment. J Matern Fetal Neonatal Med. 2006;19:375-6. PMID: 16801316
5. Festini F, Ciuti R, Repetto T et al. Safety of breast-feeding during an IV tobramycin course for infants of CF women. Pediatr Pulmonol Suppl. 2004;27:288-9. Abstract. DOI: doi:10.1002/ppul.20143

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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