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Azlocillin + tobramycin is a combination of two antibiotics used primarily for the treatment of infections caused by Gram-negative bacteria, especially Pseudomonas aeruginosa. Azlocillin is an extended-spectrum acylampicillin (a beta-lactam antibiotic) that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to cell lysis. Tobramycin is an aminoglycoside antibiotic that binds to the bacterial 30S and 50S ribosomal subunits, preventing formation of the 70S initiation complex and thereby inhibiting protein synthesis, resulting in bactericidal activity. The combination has demonstrated in vitro synergy against Pseudomonas aeruginosa and has been studied in animal models (e.g., chronic osteomyelitis in rabbits) as well as clinical settings such as acute pulmonary exacerbations in cystic fibrosis patients[1][2][5][9]. This synergistic effect may be due to enhanced penetration or complementary mechanisms of action.
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