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Published on: January 9, 2019
Gentamicin Exposure and Sensorineural Hearing Loss in Preterm Infants
Aline Fuchs1, Lara Zimmermann2, Myriam Bickle Graz2
1Division of Clinical Pharmacology, Service of Biomedicine, Department of Laboratories, Lausanne University Hospital, Lausanne, Switzerland.
Insights
Gentamicin exposure did not significantly increase sensorineural hearing loss (SNHL) risk in very low birth weight (VLBW) infants. Short-duration gentamicin treatments, blood level monitoring, and dose adjustments can minimize SNHL risks.
Area of Science:
- Neonatal Medicine
- Pediatric Audiology
- Pharmacology
Background:
- Very low birth weight (VLBW) infants are susceptible to gentamicin-induced ototoxicity.
- Sensorineural hearing loss (SNHL) is a significant concern in VLBW infants.
- The direct impact of gentamicin on SNHL in VLBW infants requires further investigation.
Purpose of the Study:
- To evaluate the association between gentamicin exposure and sensorineural hearing loss (SNHL) in very low birth weight (VLBW) infants.
- To identify risk factors and protective measures related to gentamicin use in this vulnerable population.
Main Methods:
- A case-control study involving VLBW infants (<1500g or <32 weeks gestational age) with SNHL.
- Controls were matched for gender, gestational age, birthweight, and year of birth.
- Gentamicin exposure, dosage, duration, and serum levels were analyzed.
Main Results:
- The incidence of SNHL in the VLBW population was 1.58%.
- No significant difference in gentamicin treatment proportion, cumulative dose, or duration was observed between SNHL cases and controls.
- Key pharmacokinetic parameters of gentamicin did not differ between groups.
Conclusions:
- Gentamicin exposure, within the studied parameters, did not show a statistically significant impact on SNHL in VLBW infants.
- Short-duration gentamicin therapy, therapeutic drug monitoring, and dose adjustments are crucial for minimizing potential ototoxicity.
- Further research may be warranted to explore nuanced relationships and long-term outcomes.
Objective:
To evaluate the impact of gentamicin exposure on sensorineural hearing loss (SNHL) in very low birth weight (VLBW) infants.
Methods:
Exposure to gentamicin was determined in infants born between 1993 and 2010 at a gestational age < 32 weeks and/or with a birthweight < 1500 g, who presented with SNHL during the first 5 years of life. For each case, we selected two controls matched for gender, gestational age, birthweight, and year of birth.
Results:
We identified 25 infants affected by SNHL, leading to an incidence of SNHL of 1.58% in our population of VLBW infants. The proportion of infants treated with gentamicin was 76% in the study group and 70% in controls (p = 0.78). The total cumulated dose of gentamicin administered did not differ between the study group (median 10.2 mg/kg, Q1-Q3 1.6-13.2) and the control group (median 7.9 mg/kg, Q1-Q3 0-12.8, p = 0.47). The median duration of gentamicin treatment was 3 days both in the study group and the control group (p = 0.58). Maximum predicted trough serum levels of gentamicin, cumulative area under the curve and gentamicin clearance were not different between cases and controls.
Conclusion:
The impact of gentamicin on SNHL can be minimized with treatments of short duration, monitoring of blood levels and dose adjustment.
