Vestibular system in infants after systemic aminoglycoside therapy

Area of Science:

• Oto-neurology
• Pediatric pharmacology
• Vestibular system research

Background:

• Aminoglycoside antibiotics are crucial for treating infant infections but pose a risk of ototoxicity.
• Vestibular hair cell apoptosis is a known consequence of aminoglycoside toxicity.
• Infant vestibular function is not routinely assessed despite suspected aminoglycoside influence.

Purpose of the Study:

• To evaluate vestibular function in infants before and after systemic aminoglycoside therapy.
• To assess the impact of amikacin on vestibular function using caloric tests and VEMPs.
• To determine if the vestibular system is more susceptible to aminoglycoside damage than the cochlear system in infants.

Main Methods:

• 68 infants (2.5-3.5 months) were studied; 28 received amikacin (15mg/kg/day for 10-14 days), 40 were controls.
• Caloric tests and vestibular-evoked myogenic potentials (VEMPs) were performed on admission and discharge.
• Infants with other ototoxic risk factors or multiple ototoxic drugs were excluded.

Main Results:

• All initial tests were normal.
• Post-amikacin therapy, 6 infants showed no caloric response, and 4 had no VEMPs.
• Hearing thresholds remained normal in all infants throughout the study.

Conclusions:

• Infants treated with systemic amikacin may experience vestibular organ damage more often than cochlear damage.
• The horizontal semicircular canal appears more vulnerable to aminoglycoside toxicity than the saccule.
• Routine vestibular examinations are advised for infants following systemic aminoglycoside treatment.