DRUG	SUPPLIED	DOSE	COMMENTS
TOBRAMYCIN (Paeds) Mechanism of action: Aminoglycoside antibiotic Ref: 6, 44, 630 Last update: 2022-09-12	injection: 10 mg/mL, 40 mg/mL	Children:   Traditional: 2.5 mg/kg/dose IM/IV Q8H. Extended interval : 7 mg/kg/dose IV once daily Cystic Fibrosis: 4 mg/kg/dose IV Q8H. May be increased based on serum levels. Adults:  1-2.5 mg/kg/dose Q8H	Extended interval dosing should NOT be used in patients with renal dysfunction (GFR <90), CF patients, endocarditis, surgical prophylaxis, burns >20% of body or in Gram positive infections where aminoglycoside is being used with another antibiotic for synergy. Adjust dose in renal impairment. For extended interval dosing obtain baseline creatinine; for therapy beyond 7 days check creatinine at least twice weekly. Administer extended interval and traditional interval doses over 30 min. Dose may be adjusted based on serum concentrations. Therapeutic serum concentrations: Traditional dosing: Trough (pre-dose) < 2 mg/L Peak (post-dose) 6-10 mg/L (10-15 mg/L in CF) Extended interval dosing: Trough (Pre-dose) < 1 mg/mL No post-dose level is required Refer to Therapeutic Drug Monitoring Table in References and Supplementary (white pages in print copy) Standard Prescription: tobramycin__mg IM/IV Q__H (__mg/kg/24hr)