Tobramycin/dexamethasone, sold under the brand name Tobradex, is a fixed-dose combination medication in the form of eye drops and eye ointment, marketed by Alcon. The active ingredients are tobramycin (an antibiotic) and dexamethasone (a corticosteroid). It is prescribed for the treatment of pink eye in combination with bacterial infections. Contraindications
It is contraindicated with herpetic and other viral eye infections. Other contraindications include fungal and mycobacterial infections because tobramycin is inactive against those, and the corticoid acts as an immunosuppressive agent, preventing the bodys immune system from dealing with the infection. The drops are also contraindicated in patients with corneal lesions. Side effects
Similarly to other corticosteroid eye drops, side effects include hypersensitivity and, especially after long-term use, secondary eye infections, cataract (clouding of the eye lens) and increased intraocular pressure, leading to glaucoma. Consequently, the drug should not be applied longer than 24 days without further medical evaluation. Interactions
Anticholinergic eye drops potentiate the risk of increased intraocular pressure. Systemic aminoglycoside antibiotics increase toxicity for ears, nerves and kidney. Brand names
Tobrason is a brand name in Jordan. References
External links
"Dexamethasone mixture with tobramycin". Drug Information Portal. U.S. National Library of Medicine.
Therefore, more common skin conditions, like cellulitis, foreign body reaction, skin cancer, and fungal or parasitic infections, are often explored first. Overall, diagnosis and treatment of this rare skin infection is often delayed because of a lack of suspicion.Lab tests for finding M. marinum include cultures where a swab or sample is taken and grown in the laboratory. Cultures of M. marinum are fairly difficult to grow, and results may take several weeks. The culture may be negative, even if there is an active infection. Treatment may still be considered even if the test results are negative, especially if the patients history supports past fish or fish-tank exposure. In the absence of positive culture results, a skin or tissue biopsy may be a helpful test to render a microscopic diagnosis. Another technique that can be used to detect the bacteria is Polymerase Chain Reaction (PCR). A biopsy sample itself is sufficient to detect the exact type of bacteria by means of PCR. Prevention
Avoid fresh or saltwater activities if there are open cuts, scrapes, or sores on the skin, especially in water where this bacterium is known to exist. Wear heavy gloves (leather or heavy cotton) while cleaning or processing fish, especially fish with sharp spines that may cause cuts to the hands and skin. Wash hands thoroughly with soap and water after fish processing or use a waterless cleanser. Wear waterproof gloves while cleaning home aquariums or fish tanks.