Hearing loss following the application of topical neomycin

Profound, irreversible ototoxicity has been reported following oral and topical neomycin therapy. Preexisting renal disease is a known risk factor for this adverse effect. In spite of the potential hazards of this drug, it continues to be used widely both orally and topically. This is a report of a severe, permanent hearing deficit that occurred in a patient with chronic renal failure. The patient, who had developed decubitus ulcers, was treated for three weeks with topical 1% neomycin solution applied in gauze-soaked bandages. Regular hemodialysis failed to prevent this adverse effect. Caution should be exercised in selecting patients to receive prolonged neomycin therapy.