• Reference Number: HEY1429-2024
• Departments: Respiratory Medicine
• Last Updated: 1 May 2024

Introduction 

This leaflet provides information about intravenous aminoglycoside antibiotics, which have been prescribed to treat your exacerbation.

What are aminoglycoside antibiotics? 

Aminoglycoside antibiotics are a group of antibiotics used to treat bacterial infections. These include gentamicin, amikacin, tobramycin, neomycin and streptomycin. In patients with Bronchiectasis the main prescribed aminoglycoside is tobramycin. This is given to treat lung infections caused by bacteria such as Pseudomonas aeruginosa.

How is Tobramycin given?

Tobramycin is given as part of a 2 week course of intravenous antibiotics given either at home or in hospital. This can be because you are experiencing an exacerbation of your symptoms or part of your regular planned treatment. The drug will be given through an intravenous infusion and the dose will depend on your age, weight and how well your kidneys are working.

Blood tests are required throughout the course of treatment to ensure that your dose is high enough to kill the bacteria, but not too high to cause side effects. These tests will be organised by your nursing team.

What are the side effects of aminoglycosides? 

All medicines can cause side effects. Common side effects of Tobramycin are nausea & vomiting.

More serious side effects of Tobramycin include damage to your kidneys & ears.

Ear damage

Ear damage can present as dizziness, balance problems, a ringing in your ears (known as tinnitus) or hearing loss. If you experience any of these symptoms please inform the nursing team as soon as possible.

Kidney damage

We will take blood tests to monitor your kidney function during the course of treatment. The risk of experiencing these side effects increases with longer durations of treatment, higher levels of the drug in your blood and use of some other medications. It is therefore important that you have regular blood tests during your course of treatment.

Is there anything I can do? 

Please tell us if:

• you have any allergies to medicines;
• you are pregnant/breastfeeding or intending to;
• you are taking inhaled/nebulised antibiotics such as Bramitob, TOBI and Gentamicin;
• you have any other medical problems, especially:
  • Kidney problems
  • Hearing/balance problems
  • Myasthenia gravis
  • Parkinson’s disease

• you are taking any herbal/homeopathic medicines such as St. Johns Wort;
• you experience any side effects.

Will the Tobramycin interact with my other medication? 

The Bronchiectasis team will look at all of your medication and check whether there will be any interactions with the tobramycin antibiotics. It is very important that we are aware of all medication you are taking. This includes herbal medicines and other medicines which you might buy over the counter.

We strongly recommend you DO NOT take non-steroidal anti-inflammatory drugs (NSAID), such as ibuprofen, aspirin or diclofenac (Volterol) when receiving intravenous tobramycin. This is because the risk of kidney damage is greater when taking NSAID’s alongside tobramycin. If you usually take NSAID’s and/or need some pain relief during your treatment, please speak to your nursing team, doctor or pharmacist.

Who can I speak to if I have any questions?

Your nurse led Bronchiectasis team will be happy to answer any questions you may have about your treatment.

Please contact us on tel: 01482 622495