Dosing is based on patient weight. Those who are obese (>20% over IBW) should have their dose based on ideal body weight (IBW)

• Females: IBW (kg) = 45.5kg + 0.9kg for every cm over 152cm
• Males: IBW (kg) = 50kg + 0.9kg for every cm over 152cm

Doses can then be selected depending on creatinine clearance, calculated by using Cockroft Gault equation or using CrCl calculator

Calculate dose as above up to a MAXIMUM of 500mg OD.

If CrCl is <30ml/min consider alternative and discuss with microbiology/pharmacy.

Give dose in 50-100ml of Sodium chloride 0.9% over 30 minutes.

Tobramycin monitoring

Trough levels should be checked immediately before the second dose. Dose should be given and adjustment made to third dose if needed. Always consider timing of the level when interpreting results.

Trough levels should be <1mg/L, if higher please follow table below