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Nephrotoxicity and ototoxicity following irrigation of wounds with neomycin
Abstract:
Renal failure and ototoxicity developed in two patients following wound irrigation with neomycin. In both patients the renal failure was reversible, but the deafness was progressive despite withdrawal of the neomycin. In one patient the serum neomycin concentration was still markedly elevated (42 microgram/ml) 2 days after use of the drug was discontinued. The authors suggest that irrigation of large open wounds with neomycin is dangerous since toxic blood concentrations may ensue. The benefits conferred by neomycin irrigation should be weighed against the possible danger of permanently impaired hearing.
Insights
Neomycin wound irrigation can cause kidney failure and progressive deafness. High neomycin levels persisted even after stopping the drug, highlighting risks of permanent hearing loss.
Area of Science:
- Nephrology
- Ototoxicology
- Pharmacology
Background:
- Neomycin is an antibiotic commonly used topically.
- Wound irrigation with antibiotics aims to prevent infection.
Observation:
- Two patients developed renal failure and ototoxicity after wound irrigation with neomycin.
- Renal failure was reversible, but hearing loss was progressive.
Findings:
- Elevated serum neomycin concentrations were observed even days after drug discontinuation.
- This suggests significant systemic absorption and potential for toxicity.
Implications:
- Irrigating large open wounds with neomycin poses a risk of dangerous systemic concentrations.
- The potential for irreversible hearing damage necessitates careful risk-benefit assessment of neomycin wound irrigation.