tobramycin + carbamoyl adenylate <=> nebramycin 5' + AMP + H(+)
tobramycin + carbamoyl adenylate <=> nebramycin 5' + amp + h(+)
tobramycin + carbamoyl adenylate <=> nebramycin 5' + AMP + H(+)
tobramycin + carbamoyl adenylate <=> nebramycin 5' + amp + h(+)