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Augmented gentamicin ototoxicity induced by vancomycin in guinea pigs
R E Brummett1, K E Fox, F Jacobs
1Department of Otolaryngology Head and Neck Surgery, Oregon Health Sciences University, Portland.
Abstract:
Vancomycin has been reported to be an ototoxic drug in the clinical literature. At best, this literature is confusing. There are no reports of ototoxicity of vancomycin in experimental animals, even when it is administered concurrently with ethacrynic acid, a drug known to augment the ototoxic effect of most other ototoxic drugs. In most of the cases of permanent ototoxicity that have been reported, the patient was treated with an aminoglycoside antibiotic as well as vancomycin. This study found no evidence of vancomycin ototoxicity in guinea pigs, but found that vancomycin greatly enhanced the ototoxicity of gentamicin.
Insights
Vancomycin alone did not cause hearing loss in guinea pigs. However, vancomycin significantly increased the ototoxicity of gentamicin, suggesting a dangerous drug interaction.
Area of Science:
- Ototoxicology
- Pharmacology
- Neuroscience
Background:
- Clinical literature suggests vancomycin may be ototoxic, but evidence is conflicting.
- Previous animal studies have not demonstrated vancomycin-induced ototoxicity, even with ototoxicity-potentiating agents.
- Ototoxicity is often reported in patients receiving vancomycin concurrently with aminoglycoside antibiotics.
Purpose of the Study:
- To investigate the ototoxicity of vancomycin in an animal model.
- To determine if vancomycin potentiates the ototoxic effects of gentamicin.
Main Methods:
- Administration of vancomycin to guinea pigs.
- Concurrent administration of vancomycin and gentamicin to guinea pigs.
- Assessment of ototoxicity in treated guinea pigs.
Main Results:
- Vancomycin administration alone did not result in ototoxicity in guinea pigs.
- Vancomycin significantly enhanced the ototoxicity of gentamicin in guinea pigs.
- No evidence of vancomycin-induced ototoxicity was observed.
Conclusions:
- Vancomycin is not inherently ototoxic in guinea pigs.
- Vancomycin potentiates gentamicin-induced ototoxicity, highlighting a critical drug interaction.
- Clinical caution is advised when co-administering vancomycin and gentamicin.