Screening for aminoglycoside auditory toxicity in the old

Area of Science:

• Ototoxicity and Auditory Health
• Pharmacology and Drug Safety
• Audiology and Hearing Science

Background:

• Gentamicin, an aminoglycoside antibiotic, is associated with ototoxicity, a significant concern in patient care.
• Standard audiometric techniques may not fully capture early signs of gentamicin-induced hearing damage.
• The potential for underestimation of ototoxicity necessitates refined screening methods.

Purpose of the Study:

• To investigate auditory toxicity in patients receiving gentamicin.
• To evaluate a portable audiometer for screening aminoglycoside-treated patients for ototoxicity.
• To measure the error in using initial hearing thresholds as a reference point for non-ototoxic drug treatments.

Main Methods:

• Standard audiometry in a sound-treated room for 22 patients on gentamicin (Study 1).
• Evaluation of a portable audiometer for ward-based screening in 12 volunteers (Study 2).
• Measurement of hearing threshold reference error in 16 patients on non-ototoxic antibacterials (Study 3).

Main Results:

• A significant reduction in hearing threshold at 4000 Hz was detected in gentamicin-treated patients (Study 1).
• A 10 dB or greater hearing loss at 4000 Hz was significantly more common in older patients receiving gentamicin.
• Portable audiometry showed comparable precision to standard methods, with slight variations based on testing time and venue.

Conclusions:

• Gentamicin can cause significant high-frequency hearing loss, potentially underestimated by standard reference points.
• Age and gentamicin concentration correlate with hearing loss, suggesting presbycusis may increase susceptibility.
• Portable audiometry shows promise for effective ototoxicity screening in clinical settings.