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Correlation between hearing loss and peritonitis frequency and administration of ototoxic intraperitoneal antibiotics
Bulent Tokgoz1, Mehmet Akif Somdas, Cahit Ucar
1Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey. bulentto@gmail.com
Aim:
Aminoglycosides have been used in the treatment of CAPD peritonitis despite their potential risk for ototoxicity. The ototoxicity risk of intraperitoneally administered aminoglycosides has been investigated by a number of studies. However, their results are somewhat conflicting. The aim of the present study was to examine the frequency of hearing loss and the correlation between the repeated doses of aminoglycosides and hearing loss in CAPD peritonitis therapy.
Methods:
Hearing functions of the CAPD patients who had developed peritonitis and had been treated with various antibiotics including aminoglycosides were compared with those CAPD patients who had never developed peritonitis. Threshold values for hearing were determined through "pure tone audiometry" measurements.
Results:
Hearing threshold levels of the patients with history of peritonitis were found to be significantly higher in both lower [pure tone averages - 1 (PTA-1)] and higher [pure tone averages - 2 (PTA-2)] frequencies, when compared to the ones with no history of peritonitis (p values were 0.001 and 0.007, respectively).
Conclusion:
The present study showed that intraperitoneal aminoglycoside administration in CAPD patients is associated with the development of hearing loss. The severity of hearing loss may range from mild hearing loss to profound deafness. A remarkable correlation exists between the severity of the hearing loss and the repeated and total aminoglycoside dose received.
Insights
Intraperitoneal aminoglycosides for continuous ambulatory peritoneal dialysis (CAPD) peritonitis increase hearing loss risk. Repeated or total aminoglycoside doses correlate with hearing loss severity in CAPD patients.
Area of Science:
- Nephrology
- Ototoxicology
- Pharmacology
Background:
- Aminoglycosides are used for CAPD peritonitis but pose an ototoxicity risk.
- Previous studies on intraperitoneal aminoglycoside ototoxicity have yielded conflicting results.
- This study investigates hearing loss frequency and dose-response relationship in CAPD peritonitis patients.
Purpose of the Study:
- To determine the incidence of hearing loss in CAPD patients treated for peritonitis with aminoglycosides.
- To assess the correlation between cumulative aminoglycoside dosage and the severity of hearing loss.
- To compare hearing function in CAPD patients with and without a history of peritonitis.
Main Methods:
- Comparison of hearing function between CAPD patients with peritonitis (treated with aminoglycosides) and those without peritonitis.
- Utilized pure tone audiometry to measure hearing threshold values.
- Analyzed hearing thresholds at both lower (PTA-1) and higher (PTA-2) frequencies.
Main Results:
- Patients with a history of peritonitis exhibited significantly higher hearing thresholds at both lower (PTA-1) and higher (PTA-2) frequencies compared to controls (p=0.001 and p=0.007, respectively).
- A significant association was found between intraperitoneal aminoglycoside administration and the development of hearing loss.
- Hearing loss severity ranged from mild to profound deafness.
Conclusions:
- Intraperitoneal aminoglycoside use in CAPD patients is linked to hearing loss.
- A strong correlation exists between the total and repeated doses of aminoglycosides and the degree of hearing loss.
- Clinical monitoring for hearing impairment is recommended in CAPD patients receiving aminoglycoside therapy.
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