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Is intraperitoneal tobramycin ototoxic in CAPD patients?
P Nikolaidis1, S Vas, V Lawson
1Toronto Western Hospital, University of Toronto, Canada.
Summary
Intraperitoneal tobramycin in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients did not show significant auditory toxicity. While some hearing changes occurred, no clear link to tobramycin was established in this study.
Area of Science:
- Nephrology
- Ototoxicology
- Pharmacology
Background:
- Peritonitis is a common complication in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients.
- Intraperitoneal tobramycin is used to treat peritonitis in CAPD patients.
- Aminoglycosides, including tobramycin, are known for potential ototoxic side effects.
Purpose of the Study:
- To prospectively evaluate the ototoxic effects of intraperitoneal tobramycin in CAPD patients.
- To assess changes in cochlear function and speech audiometry following tobramycin treatment.
Main Methods:
- 40 CAPD patients treated for peritonitis with intraperitoneal tobramycin were studied.
- Cochlear function was evaluated using pure-tone audiograms (250-10,000 Hz).
- Speech-reception and speech-discrimination tests were performed before and after treatment.
Main Results:
- No statistically significant difference was observed between baseline and follow-up hearing levels.
- Hearing deteriorated in 25% of patients and improved in 17.5%; 57.5% had stable hearing.
- No significant correlation was found between hearing changes and risk factors like age, treatment duration, or renal function.
Conclusions:
- Intraperitoneal tobramycin at the studied doses did not confirm auditory toxicity in CAPD patients.
- Observed hearing deterioration may be due to synergistic factors, not solely tobramycin.
- The reasons for hearing improvement in some patients remain unexplained.