help. I am in hosp for my first in hosp tune up in 20 years. New hosp. Kaiser Los Angeles. I am 67 years old and 170 pounds. I have a pretty bad lung infection. They want to give me 800mg Tobramycin IV, I think once a day. I've never had more than 250mg in the past at home. Doc says it is a special CF protocol. Anyone here ever get that much tobramycin....Thanks.
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800mg tobramycin reasonable? Urgent!
- Thread starter stevehof
- Start date
Yes, your dose is a reasonable one. The CFF now recommends daily dosing of Tobramycin at 10mg/kg per day. That would be about 770 mg for you. Here’s a great article by the CFF that offers explanations to their recommendations for treatments of pulmonary exacerbations: http://www.cff.org/UploadedFiles/tr...F-Care-Guidelines-Pulmonary-Exacerbations.pdf
Refer to page 805 for an explanation about daily dosing of Tobramycin as opposed to three times daily dosing. Basically it says there’s reason to believe that daily dosing is preferable because there is an increase in bacteria kill and a decrease in toxicity. As I’m typing this I have 520 my infusing. I’m 115 pounds. I do have side effects during infusion and for about 6 hours after. I get very tired, numbness and tingling on face/lips/tongue, have a “heavy” feeling all over, and “brain fog” for lack of a better term. My doctor is aware of side effects. They usually start to decrease in intensity with each day. Make sure you have tobra levels drawn and a CMP (complete metabolic panel-electrolytes, kidney function tests,etc.). My clinic draws them with my 4[SUP]th[/SUP] dose and then once a week if levels are normal. Tobra can be harsh on the kidneys. I usually opt for 1 liter of IV fluids over 3 hours to make sure I’m well hydrated. Tobra can also affect your hearing so make sure you make your doctor aware of any ringing in your ears or dizziness. Although it has its risks, it is one of the few drugs that my Pseudomonas responds to so I don’t have much of a choice. Good luck to you. I hope you feel better soon.
Refer to page 805 for an explanation about daily dosing of Tobramycin as opposed to three times daily dosing. Basically it says there’s reason to believe that daily dosing is preferable because there is an increase in bacteria kill and a decrease in toxicity. As I’m typing this I have 520 my infusing. I’m 115 pounds. I do have side effects during infusion and for about 6 hours after. I get very tired, numbness and tingling on face/lips/tongue, have a “heavy” feeling all over, and “brain fog” for lack of a better term. My doctor is aware of side effects. They usually start to decrease in intensity with each day. Make sure you have tobra levels drawn and a CMP (complete metabolic panel-electrolytes, kidney function tests,etc.). My clinic draws them with my 4[SUP]th[/SUP] dose and then once a week if levels are normal. Tobra can be harsh on the kidneys. I usually opt for 1 liter of IV fluids over 3 hours to make sure I’m well hydrated. Tobra can also affect your hearing so make sure you make your doctor aware of any ringing in your ears or dizziness. Although it has its risks, it is one of the few drugs that my Pseudomonas responds to so I don’t have much of a choice. Good luck to you. I hope you feel better soon.
Thanks for that info. At least I know it was a good decision based on official protocols. A different doc on the CF team came by this morning and changed out Tobra for Zosyn. I have no problem with Tobra but at 67 and already needing two hearing aids, and being marginal on Creatinine <sp> from time to time, there's no way I'm going to risk a super high dose of Tobra when my life is not in jeopardy. I wonder how many 65 year old CF'ers were in on the study that developed that particular protocol?