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Tobramycin
MessagePerforming Lab: Regions
Test Code
0592
Alias/See Also
Sunquest: TOBR
CPT Codes
80200
Preferred Specimen
0.2 mL Lithium Heparin Plasma (light green-top) tube
Minimum Volume
0.1 mL
Other Acceptable Specimens
Serum (gold-top, red-top, red/gray-top), Lithium Heparin (light green-top) on ICE
Instructions
Collection: Samples for peak concentrations should be collected between 60 and 90 minutes after intravenous infusion. Samples for trough concentrations should be collected within 30 minutes of the next dose.
Processing: Centrifuge specimens and remove the serum or plasma from cellular material within 1 hour of collection.
Processing: Centrifuge specimens and remove the serum or plasma from cellular material within 1 hour of collection.
Transport Temperature
Refrigerated
Specimen Stability
Room Temperature: 2 hours
Refrigerated: 7 days
Frozen: 14 days
Refrigerated: 7 days
Frozen: 14 days
Methodology
Two-Point Rate
Setup Schedule
Daily
Report Available
Same Day
Limitations
For patients receiving tobramycin via conventional dosing methods peak and trough drug monitoring should begin after a steady state is achieved (usually after 3–4 doses).
Reference Range
Trough Levels: <2.0 mcg/mL
Peak Levels: 4.0 - 12.0 mcg/mL
Critical Value: >= 12 mcg/mL
Peak Levels: 4.0 - 12.0 mcg/mL
Critical Value: >= 12 mcg/mL
Clinical Significance
Tobramycin is used in the treatment of serious infections caused by susceptible strains of gram-negative microorganisms and particular gram-positive organisms that are resistant to less toxic antibiotics. Tobramycin is safe and effective only in a narrow range of concentrations for a given indication. Exposure to high tobramycin concentrations for a prolonged period may cause renal impairment or ototoxicity. Serum or plasma tobramycin measurements are used in the diagnosis and treatment of tobramycin overdose and in monitoring levels of tobramycin to ensure appropriate therapy
