Tobramycin


Sunquest Code:TOBRA  
Epic Code:LAB3777Epic Name:Tobramycin
Methodology:Turbidimetric rate
Turnaround Time:Performed and reported 24 hours/day.
Special Instructions:Comment last dose information on request form.


Collection Instructions

Specimen:Blood
Optimal Volume:2.5 mL
Minimum\Peds Volume:0.6 mL; pediatric patients only: 0.4 mL in green (lithium heparin, no gel)
Container:Red (no gel), St Johns/St Joseph/Woodwinds-Green (lithium heparin, no gel)
[Alternate Containers: Green (lithium heparin, no gel), St Johns/St Joseph/Woodwinds - Red (no gel)]
Collection Instructions:Trough levels: Collect immediately prior to next dose. Peak levels: collect 60 minutes after the end of IV infusion; 1-2 hours if decreased renal function.
Causes for Rejection:Processed >2 hours after collection; sample not analyzed or frozen within 4 hours. Collection in a gel tube.


Processing and Shipping

Specimen Processing:Process within 2 hours. Centrifuge and aliquot 1.25 mL, 0.2 mL minimum (adult) 0.1 mL minimum (peds). If assaying is delayed more than 4 hours, then aliquot and freeze the sample.
Shipping Instructions:Ship on dry ice.
Stability:Beta-lactam antibiotics and cephalosporins will inactivate aminoglycosides, causing falsely low results.
Stability is 4 hours at room temperature or refrigerated; 1 month frozen.
Test Performed at or Referral Lab Chemistry  (UMMC-East Bank, Lakes, Southdale, UMMC/UMMCH-West Bank, St. Joseph's)


Interpretive

Critical Range:Greater than 16 mg/L for traditional dosing; Greater than 35 mg/L for single daily dosing
Therapeutic Range:Trough <1 mg/L; Peak: 5.0-12.0 mg/L, depending on dosage.
Use:Monitor therapeutic dosing and evaluate toxicity. Half-life is 1.5-3 h (adult less than 30 y); 3-6 h (adult 30 y or greater); 4-8 h (neonate).


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