U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Tobramycin response

MedGen UID:
776648
Concept ID:
CN184545
Sign or Symptom
Drug:
Tobramycin
MedGen UID:
21572
Concept ID:
C0040341
Antibiotic
An aminoglycoside antibiotic derived from Streptomyces tenebrarius with bacteriostatic activity. Following active transport into the cell, tobramycin binds irreversibly to a specific aminoglycoside receptor on the bacterial 30S ribosomal subunit and interferes with the initiation complex between messenger RNA and the 30S subunit, thereby inhibiting initiation of protein synthesis, consequently leading to bacterial cell death. In addition, tobramycin induces misreading of the mRNA template causing incorrect amino acids to be incorporated into the growing polypeptide chain, consequently interfering with protein elongation. [from NCI]
 
Genes (locations): MT-RNR1; MT-TS1; RNR1 (13p12); TRMU (22q13.31)

Definition

Aminoglycosides are widely used antibiotics which inhibit protein synthesis in bacteria by binding to bacterial 16S ribosomal subunits. Aminoglycosides are associated with a number of adverse events, including nephrotoxicity and ototoxicity. The risk of aminoglycoside-induced ototoxicity is increased in patients who carry certain variants in the MT-RNR1 gene. MT-RNR1 is found in the mitochondrial genome and encodes the 12S ribosomal subunit. Some MT-RNR1 variants cause the 12S subunit to more closely resemble the bacterial 16S subunit, which can lead to aminoglycoside molecules binding to the ribosome. This ultimately results in hearing loss due to cell death in the cochlea. The Clinical Pharmacogenetics Implementation Consortium (CPIC) have published recommendations on aminoglycoside use in patients carrying MT-RNR1 variants in the journal Clinical Pharmacology and Therapeutics. These recommendations are also available on the CPIC and PharmGKB websites. [from PharmGKB]

Additional description

From GeneReviews
Mitochondrial nonsyndromic hearing loss and deafness is characterized by sensorineural hearing loss (SNHL) of variable onset and severity. Pathogenic variants in MT-RNR1 can be associated with predisposition to aminoglycoside ototoxicity and/or late-onset SNHL. Hearing loss associated with aminoglycoside ototoxicity is bilateral and severe to profound, occurring within a few days to weeks after administration of any amount (even a single dose) of an aminoglycoside antibiotic such as gentamycin, tobramycin, amikacin, kanamycin, or streptomycin. Pathogenic variants in MT-TS1 are usually associated with childhood onset of SNHL that is generally nonsyndromic – although the MT-TS1 substitution m.7445A>G has been found in some families who also have palmoplantar keratoderma (scaling, hyperkeratosis, and honeycomb appearance of the skin of the palms, soles, and heels).

Term Hierarchy

Professional guidelines

PubMed

Rouillard KR, Esther CP, Kissner WJ, Plott LM, Bowman DW, Markovetz MR, Hill DB
PLoS One 2024;19(2):e0294120. Epub 2024 Feb 23 doi: 10.1371/journal.pone.0294120. PMID: 38394229Free PMC Article
Comstock TL, Holland EJ
Expert Opin Pharmacother 2010 Apr;11(5):843-52. doi: 10.1517/14656561003667532. PMID: 20210687
Bodey GP, Ketchel S, Rodriguez V
J Infect Dis 1978 May;137 Suppl:S139-S143. doi: 10.1093/infdis/137.supplement.s139. PMID: 649998

Curated

DailyMed Drug Label, tobramycin, 2022

DailyMed Drug Label, TOBRAMYCIN, 2013

Recent clinical studies

Etiology

Akkerman-Nijland AM, Akkerman OW, Grasmeijer F, Hagedoorn P, Frijlink HW, Rottier BL, Koppelman GH, Touw DJ
Expert Opin Drug Metab Toxicol 2021 Jan;17(1):53-68. Epub 2020 Dec 29 doi: 10.1080/17425255.2021.1836157. PMID: 33213220
Felix LM, Grundy S, Milan SJ, Armstrong R, Harrison H, Lynes D, Spencer S
Cochrane Database Syst Rev 2018 Jun 11;6(6):CD012514. doi: 10.1002/14651858.CD012514.pub2. PMID: 29889304Free PMC Article
Comstock TL, Holland EJ
Expert Opin Pharmacother 2010 Apr;11(5):843-52. doi: 10.1517/14656561003667532. PMID: 20210687
Alexandrakis G, Palma LA, Miller D, Alfonso EC
Ophthalmology 2000 Aug;107(8):1503-6. doi: 10.1016/s0161-6420(00)00227-x. PMID: 10919898
Rubinstein E, Lode H, Grassi C
Clin Infect Dis 1995 May;20(5):1217-28. doi: 10.1093/clinids/20.5.1217. PMID: 7620002

Diagnosis

Zahraee H, Khoshbin Z, Ramezani M, Alibolandi M, Abnous K, Taghdisi SM
Spectrochim Acta A Mol Biomol Spectrosc 2023 Apr 5;290:122305. Epub 2023 Jan 2 doi: 10.1016/j.saa.2022.122305. PMID: 36603274
Felix LM, Grundy S, Milan SJ, Armstrong R, Harrison H, Lynes D, Spencer S
Cochrane Database Syst Rev 2018 Jun 11;6(6):CD012514. doi: 10.1002/14651858.CD012514.pub2. PMID: 29889304Free PMC Article
Patel R, Sise A, Al-Mohtaseb Z, Garcia N, Aziz H, Amescua G, Pantanelli SM
Cornea 2015 Dec;34(12):1617-9. doi: 10.1097/ICO.0000000000000634. PMID: 26418432
Alexandrakis G, Palma LA, Miller D, Alfonso EC
Ophthalmology 2000 Aug;107(8):1503-6. doi: 10.1016/s0161-6420(00)00227-x. PMID: 10919898
Bannatyne RM, Cheung R
Antimicrob Agents Chemother 1981 Oct;20(4):493-5. doi: 10.1128/AAC.20.4.493. PMID: 6979305Free PMC Article

Therapy

Comstock TL, Holland EJ
Expert Opin Pharmacother 2010 Apr;11(5):843-52. doi: 10.1517/14656561003667532. PMID: 20210687
Alexandrakis G, Palma LA, Miller D, Alfonso EC
Ophthalmology 2000 Aug;107(8):1503-6. doi: 10.1016/s0161-6420(00)00227-x. PMID: 10919898
Prins JM, Speelman P
Neth J Med 1998 Jan;52(1):1-9. doi: 10.1016/s0300-2977(97)00071-5. PMID: 9573735
Nicolau D, Quintiliani R, Nightingale CH
Conn Med 1992 Oct;56(10):561-3. PMID: 1458882
Bannatyne RM, Cheung R
Antimicrob Agents Chemother 1981 Oct;20(4):493-5. doi: 10.1128/AAC.20.4.493. PMID: 6979305Free PMC Article

Prognosis

Natale S, Bradley J, Nguyen WH, Tran T, Ny P, La K, Vivian E, Le J
Pharmacotherapy 2017 Mar;37(3):361-378. Epub 2017 Feb 27 doi: 10.1002/phar.1899. PMID: 28079262
Patel R, Sise A, Al-Mohtaseb Z, Garcia N, Aziz H, Amescua G, Pantanelli SM
Cornea 2015 Dec;34(12):1617-9. doi: 10.1097/ICO.0000000000000634. PMID: 26418432
Comstock TL, Holland EJ
Expert Opin Pharmacother 2010 Apr;11(5):843-52. doi: 10.1517/14656561003667532. PMID: 20210687
Alexandrakis G, Palma LA, Miller D, Alfonso EC
Ophthalmology 2000 Aug;107(8):1503-6. doi: 10.1016/s0161-6420(00)00227-x. PMID: 10919898
Feld R, Louie TJ, Mandell L, Bow EJ, Robson HG, Chow A, Belch A, Miedzinski L, Rachlis A, Pater J
Arch Intern Med 1985 Jun;145(6):1083-8. PMID: 3890789

Clinical prediction guides

Gras E, Vu TTT, Nguyen NTQ, Tran VG, Mao Y, Tran ND, Mai NH, Dong OX, Jung DH, Iorio NLPP, Povoa HCC, Pinheiro MG, Aguiar-Alves F, Weiss WJ, Zheng B, Cheng LI, Stover CK, Sellman BR, DiGiandomenico A, Gibault L, Valour F, Diep BA
Front Cell Infect Microbiol 2023;13:1297281. Epub 2023 Dec 11 doi: 10.3389/fcimb.2023.1297281. PMID: 38149013Free PMC Article
Almatrood W, Nakouti I, Hobbs G
Arch Microbiol 2022 May 4;204(6):297. doi: 10.1007/s00203-022-02877-y. PMID: 35508818Free PMC Article
Comstock TL, Holland EJ
Expert Opin Pharmacother 2010 Apr;11(5):843-52. doi: 10.1517/14656561003667532. PMID: 20210687
Feld R, Louie TJ, Mandell L, Bow EJ, Robson HG, Chow A, Belch A, Miedzinski L, Rachlis A, Pater J
Arch Intern Med 1985 Jun;145(6):1083-8. PMID: 3890789
Ristuccia AM, Cunha BA
Ther Drug Monit 1985;7(1):12-25. doi: 10.1097/00007691-198503000-00003. PMID: 3887667

Recent systematic reviews

Jiao Y, Moya B, Chen MJ, Zavascki AP, Tsai H, Tao X, Sutaria DS, Louie A, Boyce JD, Deveson Lucas D, Kim TH, Tsuji BT, Bonomo RA, Drusano GL, Bulitta JB
Antimicrob Agents Chemother 2019 Jul;63(7) Epub 2019 Jun 24 doi: 10.1128/AAC.00425-19. PMID: 30988147Free PMC Article
Felix LM, Grundy S, Milan SJ, Armstrong R, Harrison H, Lynes D, Spencer S
Cochrane Database Syst Rev 2018 Jun 11;6(6):CD012514. doi: 10.1002/14651858.CD012514.pub2. PMID: 29889304Free PMC Article
Uttley L, Harnan S, Cantrell A, Taylor C, Walshaw M, Brownlee K, Tappenden P
Eur Respir Rev 2013 Dec;22(130):476-86. doi: 10.1183/09059180.00001513. PMID: 24293463Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    Consumer resources

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...