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Gentamicin administration via peritoneal dialysis fluid: the risk of ototoxicity
1ENT Department, Faculty of Medicine, National University of Malaysia, Kuala Lumpur.
Abstract:
In a prospective study on 47 patients, 16 mg of gentamicin per two litres dialysate was administered intraperitoneally at every cycle of intermittent peritoneal dialysis, carried out over the course of several days. Serum gentamicin sampling, pure tone audiometry and caloric tests were performed before and during the treatment. The gentamicin levels reached at the end of the thirtieth cycle were observed to be low. In view of this, the risk of acute ototoxicity was considered to be minimal. This was confirmed by the absence of clinical audiometric or vestibulometric evidence of toxicity.
Insights
This study found low gentamicin levels during peritoneal dialysis, suggesting minimal risk of ototoxicity. Audiometric and vestibulometric tests confirmed no signs of hearing or balance toxicity.
Area of Science:
- Nephrology
- Pharmacology
- Ototoxicology
Background:
- Peritoneal dialysis is a common renal replacement therapy.
- Gentamicin is an antibiotic sometimes used in dialysis patients.
- Ototoxicity is a potential side effect of gentamicin.
Purpose of the Study:
- To assess serum gentamicin levels in patients undergoing intermittent peritoneal dialysis.
- To evaluate the risk of ototoxicity associated with intraperitoneal gentamicin administration during dialysis.
Main Methods:
- Prospective study involving 47 patients.
- Intraperitoneal administration of 16 mg gentamicin per 2 L dialysate per cycle.
- Serum gentamicin sampling, pure tone audiometry, and caloric tests performed before and during treatment.
Main Results:
- Low serum gentamicin levels were observed at the 30th cycle.
- No clinical evidence of ototoxicity (hearing impairment) was detected.
- No vestibulometric evidence of toxicity (balance issues) was found.
Conclusions:
- Intraperitoneal gentamicin at the studied dose during intermittent peritoneal dialysis is associated with minimal risk of acute ototoxicity.
- The observed low serum concentrations support the safety profile regarding auditory and vestibular function.