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Abstract:
In the introduction the main importance of the total dose of administered aminoglycoside antibiotics for ototoxicity is stressed. Within the clinical ototoxicity dose range fewer than 2% of the patients with no ototoxicity increasing factors are at risk of irreversible ototoxic damage. Within the absolute ototoxicity range this risk is less than 0.2%. On the basis of clinical and experimental experience of the different aminoglycoside antibiotics, the values for the clinical and absolute ototoxicity threshold doses of the modern aminoglycoside antibiotics are indicated. For gentamicin, these values amount to 50 and 20 mg/kg respectively and for amikacin to 120 and 50 mg/kg body weight respectively.
Insights
Aminoglycoside antibiotics can cause ototoxicity, with risks of irreversible damage being low (<2%) within clinical dose ranges. Specific threshold doses for gentamicin and amikacin are provided to guide safe clinical use.
Area of Science:
- Pharmacology
- Toxicology
- Ototoxicology
Context:
- Aminoglycoside antibiotics are widely used but carry a risk of ototoxicity.
- Understanding dose-dependent ototoxicity is crucial for patient safety.
- Identifying threshold doses helps in managing treatment risks.
Purpose:
- To stress the importance of total administered aminoglycoside dose in ototoxicity.
- To define clinical and absolute ototoxicity threshold doses for modern aminoglycoside antibiotics.
- To provide specific threshold dose values for gentamicin and amikacin.
Summary:
- The risk of irreversible ototoxic damage from aminoglycosides is low (<2%) within clinical dose ranges for patients without additional risk factors.
- The risk decreases further (<0.2%) within the absolute ototoxicity range.
- Based on clinical and experimental data, threshold doses were determined: gentamicin (50 mg/kg clinical, 20 mg/kg absolute) and amikacin (120 mg/kg clinical, 50 mg/kg absolute).
Impact:
- Provides critical data for clinicians to minimize ototoxicity risk when prescribing aminoglycosides.
- Establishes evidence-based guidelines for safe aminoglycoside dosing.
- Contributes to the understanding of aminoglycoside-induced ototoxicity and its management.