Q: Nebulized Tobramycin has high systemic absorption, so it should be used with caution in ICU as a nebulizer treatment, and should be discontinued if creatinine goes up?

A) True
B) False


Answer:  False 

 Tobramycin except for intravenous or intramuscular route has negligible systemic absorption. There is no oral formulation available as it does not get absorb via GI tract. It is very safe to use as ophthalmic drops or as nebulised treatments.

Bonus pearls:

• Tobramycin works very well in life-threatening Yersinia pestis (plague).
• Tobramycin has better penetration in lungs over gentamicin for pseudomonas pneumonia.