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[Ototoxicity of aminoglycoside antibiotics]
1Klinik für Hals-Nasen-Ohrenheilkunde, Städtisches Klinikum Görlitz. reiss@klinikum-goerlitz.de
Abstract:
In gram-negative infections aminoglycosides still remain to present a first-line antibiotic. Their use is limited by the high risk for side effects and especially nephrotoxicity and ototoxicity. The more recently developed members of this group, although purporting to be less ototoxic, are also capable of producing inner ear damage in sufficiently high doses. This paper reviews the morphological, histochemical, and electrophysiological evidence concerning the mode of action of aminoglycosides on the auditory and vestibular systems and discusses the available methods for the detection of possible clinical ototoxicity. With recent advances in aminoglycoside monitoring techniques, the risk of toxicity has been greatly reduced. Guidelines are proposed about the prevention of ototoxicity and the management of patients with established auditory or vestibular dysfunction.
Insights
Aminoglycoside antibiotics are crucial for gram-negative infections but can cause hearing and balance problems. Monitoring techniques have reduced toxicity risks, aiding in prevention and management of auditory and vestibular dysfunction.
Area of Science:
- Pharmacology
- Ototoxicology
- Infectious Diseases
Background:
- Aminoglycosides are first-line antibiotics for gram-negative infections.
- Nephrotoxicity and ototoxicity are significant limitations to aminoglycoside use.
- Newer aminoglycosides may have reduced ototoxicity but can still cause inner ear damage.
Purpose of the Study:
- To review evidence on aminoglycoside ototoxicity mechanisms.
- To discuss methods for detecting clinical ototoxicity.
- To propose guidelines for preventing and managing aminoglycoside-induced ototoxicity.
Main Methods:
- Review of morphological, histochemical, and electrophysiological studies.
- Analysis of clinical ototoxicity detection methods.
- Synthesis of data for guideline development.
Main Results:
- Aminoglycosides damage auditory and vestibular systems through specific mechanisms.
- Advances in monitoring have decreased toxicity risks.
- Effective methods for detecting ototoxicity exist.
Conclusions:
- Aminoglycoside ototoxicity is a serious concern, but risks are manageable.
- Monitoring and adherence to guidelines can prevent and manage inner ear damage.
- Further research and clinical vigilance are essential for safe aminoglycoside therapy.