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Gentamicin - Progressive cochlear toxicity.

V S Dayal, G L Whitehead, E L Smith

    Canadian Journal of Otolaryngology
    |January 1, 1975
    PubMed
    Summary
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    Topical Gentamicin application to severe burns caused hearing and vestibular loss in four patients. This ototoxicity occurred even without kidney damage, highlighting absorption risks from extensive skin injuries.

    Area of Science:

    • Ototoxicology
    • Burn Medicine
    • Pharmacology

    Background:

    • Gentamicin is a widely used antibiotic, but its potential for ototoxicity is a known concern.
    • Severe thermal burns create large surface areas that may enhance drug absorption.
    • The risk of systemic absorption and subsequent toxicity from topical antibiotic application in burn patients requires careful evaluation.

    Purpose of the Study:

    • To report cases of Gentamicin-induced cochlear and vestibular toxicity in patients with severe thermal burns.
    • To investigate the occurrence of ototoxicity following topical Gentamicin application.
    • To assess the relationship between burn surface area, Gentamicin absorption, and neurological side effects.

    Main Methods:

    • Case series of four patients with severe thermal burns treated with topical Gentamicin.

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  • Audiological and vestibular function assessments were performed.
  • Clinical monitoring for renal function and systemic Gentamicin levels (where applicable) was conducted.

    • Main Results:

    • All four patients exhibited Gentamicin-induced cochlear toxicity, resulting in moderate to severe hearing loss.
    • Hearing loss was progressive in three patients during follow-up.
    • Associated vestibular dysfunction was observed in all patients; none had renal failure during treatment.

    Conclusions:

    • Topical application of Gentamicin to large surface area burns can lead to significant cochlear and vestibular toxicity.
    • Systemic absorption and subsequent ototoxicity are possible even without impaired renal function.
    • These findings underscore the need for cautious use of topical Gentamicin in extensive burn injuries.