Guidelines
Tobramycin Sulfate Neonatal Dosing

Tobramycin Sulfate Neonatal Dosing

Age

PCA = postconceptional age (gestational age (weeks) + postnatal age (weeks))

Administration

  • In the NICU and IN all doses are to be infused by syringe pump over 30 minutes
  • Aminoglycoside antibiotics (amikacin, gentamicin, tobramycin) may be inactivated by ampicillin when infused through the same IV line right after ampicillin. For all first doses of ampicillin and tobramycin administer the antibiotics one right after another using the following procedure:

    • Administer ampicillin first
    • Flush manually at the medication port with 3mL of NS. IF you have a PICC, you must use a pump (attach the NS pre-filled sterile syringe tubing to the medication port and press the "volume over time" feature; set it for 3mL over 5 minutes)
    • Administer the tobramycin
    • For all subsequent doses, schedule the administration times so that the antibiotics are given 1 hour apart from each other
    • NOTE: Ampicillin and tobramycin can be administered at the same time without flushing or separation of administration times when each drug is infused through a separate PIV line or through different lumens of a double or triple lumen catheter