Hostname: page-component-77c89778f8-rkxrd Total loading time: 0 Render date: 2024-07-24T13:18:59.584Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical monitoring of the effects of gentamicin by electrocochleography*

Published online by Cambridge University Press:  29 June 2007

Malcolm Keene  and
John M. Graham
Malcolm Keene
Affiliation:
London
John M. Graham
Affiliation:
London
Get access Rights & Permissions [Opens in a new window]

Abstract

Eight patients receiving prolonged treatment with gentamicin for bacterial endocarditis were monitored for possible ototoxicity using transtympanic electrocochleography as an adjunct to pure tone audiometry, vestibular function tests and serum gentamicin levels. An immediate effect of intravenous gentamicin on the cochlea, shown by changes in the whole nerve action potential and/or cochlear microphonic was recorded in seven patients, none of whom had experienced vestibular or auditory symptoms with gentamicin prior to testing. Two patients subsequently developed evidence of vestibular dysfunction, and a high frequency sensorineural hearing loss occurred in a third individual. There have been no previous report of the immediate effects of gentamicin on the human cochlea to date. The significance of these findings in routine clinical monitoring of ototoxicity is discussed in the light of clinical and animal evidence for the possible mode of action of aminoglycosides on the auditory and vestibular apparatus.

Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 98 , Issue 1 , January 1984 , pp. 11 - 21
Copyright
Copyright © JLO (1984) Limited 1984

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aran, J. M., and Le Bert, G. (1968) Les résponses nerveuses cochléaires chez l'homme, image due fonctionnement de l'oreille et nouveau test d'Audiometrie objective. Revue de Laryngologie (Bordeaux), 89: 361–378.Google Scholar
Bagger-Sjöbäck, D., and Wersäll, J. (1978) Gentamicin induced mitochondrial damage in inner ear sensory cells of the lizard calotes versicolor. Acta Otolaryngologica, 86: 35–51.Google Scholar
Brummett, R. E., Fox, K. E., Bendrick, T. W., and Himes, D. L. (1978) Ototoxicity oftobramycin, gentamicin, amikacin and sisomicin in the guinea pig. Journal of Antimicrobial Chemotherapy, 4 (Supplement A): 73–83.Google Scholar
Federspil, P., Schatzle, W., and Tiesler, E. (1977) Pharmacokinetics, histological and histochemical investigation of the ototoxicity of gentamicin, tobramycin and amikacin. Archives of Otorhinolaryngology, 217: 147–166.Google Scholar
Graham, J. M., and Beagley, H. (1978) Electric response audiometry. Chapter in Recent advances in ENT. Eds. Bull, T. R., Ransome, J. and Holden, H. B., Churchill Livingstone, London.Google Scholar
Hawkins, J. E. (1976) Drug ototoxicity. Volume V, Handbook of sensory physiology. Eds. Keidel, W. D. and Neff, W. D., pp. 707–748. Springer Verlag, Berlin.Google Scholar
Hinshaw, H. C., and Feldman, W. H. (1945) Streptomycin in the treatment of clinical tuberculosis: a preliminary report. Proceedings of the Mayo Clinic, 20: 313–318.Google Scholar
Jackson, G. G., and Arcieri, G. (1971) Ototoxicity of gentamicin in man: a survey and controlled analysis of clinical experience in the United States. Journal of Infectious Diseases, Supplement 124: 130–137.Google Scholar
Jarlstedt, J., and Bagger-Sjöbäck, D. (1977) Gentamicin induced changes in RNA content in sensory and ganglionic cells in the hearing organ of the lizard calotes versicolor. Acta Otolaryngologica, 84: 361–369.Google Scholar
Jarlstedt, J., and Bagger-Sjöbäck, D. (1977) Quantitative analysis of RNA in isolated inner ear cells after gentamicin treatment. Inner Ear Biology. Eds. Portmann, M. and Aran, J. M.. Vol. 68, pp. 377–384.Google Scholar
Kiang, N.Y-S., Moxon, E. C., and Levene, R. A. (1970) Auditory nerve activity in cats with normal and abnormal cochleas. In CIBA Symposium on sensorineural hearing loss. Eds. Wolstenholme, G. E. W. and Knight, J., pp. 241–273. Churchill, London.Google Scholar
Myers, R. M. (1970) Ototoxic effects of gentamicia. Archives of Otolaryngology, 92: 160–162.Google Scholar
Noone, P., Parsons, T. M. C., Pattison, J. R., Slack, R. C. B., Garfield Davies, D., and Hughes, K. (1974) Experience in monitoring gentamicin therapy during treatment of serious gram-negative sepsis. British Medical Journal, 1: 477–481.Google Scholar
Ramsden, R. T., Wilson, P., and Gibson, W. P. R. (1980) Immediate effects of intravenous tobramycin and gentamicin on human cochlear function. Journal of Laryngology and Otology, 94: 521–531.Google Scholar
Schacht, J., Lodhi, S., Weiner, N. D. (1977) Effects of neomycin on polyphosphoinositides in inner ear tissues and monomolecular films. Membrane Toxicity. Eds. Miller, M. W. and Shamoo, A. E., pp. 191–208. Plenum Press.CrossRefGoogle Scholar
Wersäll, J., Björkroth, B., and Lundquist, P. G. (1969) Ototoxicity of gentamicin. Journal of Infectious Diseases, 119: 410–416.Google Scholar
Wersäll, J., Björkroth, B., Flock, A., and Lundquist, P. G. (1971) Sensory hair fusion in vestibular sensory cells after gentamicin exposure. Archive fur Klmische und experimentelle Ohren-Nasen-und Kehlkopfheilkunde, 200: 1–14.Google Scholar
Wersäll, J., Björkroth, B., Flock, A., and Lundquist, P. G. (1973) Experiments on ototoxic effects of antibiotics. Advances in Otorhinolaryngology, 20: 14–41, (Karger, Basel).Google Scholar
Wilson, P., and Ramsden, R. T. (1977) Immediate effects of tobramycin on human cochlea and correlation with serum tobramycin levels. British Medical Journal, 1: 259–261.Google Scholar