Tobramycin sulfate is an aminoglycoside antibiotic used to treat serious bacterial infections, particularly those caused by Gram-negative bacteria such as Pseudomonas aeruginosa, Klebsiella, Escherichia coli, and Proteus spp. It also has activity against methicillin-sensitive Staphylococcus aureus (MSSA). Commonly prescribed for respiratory tract infections, urinary tract infections, skin infections, eye infections, and ear infections. Frequently used in ophthalmic and otic formulations for bacterial conjunctivitis, keratitis, and otitis externa. Also available in inhaled form for managing chronic lung infections due to P. aeruginosa in cystic fibrosis patients. Effective in treating infections in hospitalized patients, especially when resistance to other aminoglycosides is present. Often used in combination with other antibiotics to enhance bacterial coverage. It acts by binding to the 30S ribosomal subunit, inhibiting bacterial protein synthesis, leading to bacterial death. Administration should be under medical supervision to monitor for potential side effects, including ototoxicity and nephrotoxicity, and to prevent antibiotic resistance.