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Gentamicin ototoxicity in continuous ambulatory peritoneal dialysis
1Department of ENT, National University of Malaysia (NUM), Kuala Lumpar.
The Journal of Laryngology and Otology
|August 1, 1993
Summary
Gentamicin treatment for peritonitis in chronic renal failure patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) showed no serum accumulation. However, repeated courses led to vestibular disturbances like disequilibrium and oscillopsia.
Area of Science:
- Nephrology
- Pharmacology
- Ototoxicology
Background:
- Chronic renal failure (CRF) patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) are susceptible to peritonitis.
- Gentamicin is used to treat peritonitis, but its ototoxicity is a concern.
Purpose of the Study:
- To assess serum gentamicin levels and evaluate ototoxicity in CRF patients undergoing CAPD with repeated gentamicin treatment for peritonitis.
Main Methods:
- Prospective study of 10 CRF patients on CAPD treated with gentamicin for peritonitis.
- Intraperitoneal gentamicin dosing regimen monitored.
- Serum gentamicin levels analyzed by enzyme immunoassay.
- Ototoxicity assessed via pure tone audiometry, electronystagmography, and clinical evaluation.
Main Results:
- Mean serum gentamicin levels were within the therapeutic range (5.2 µg/ml) with no observed accumulation.
- No ototoxicity was detected during the first two treatment courses.
- Disequilibrium and oscillopsia occurred during the third and fourth treatment courses.
Conclusions:
- Intraperitoneal gentamicin for CAPD peritonitis does not appear to accumulate in serum.
- Repeated gentamicin courses may cause cumulative vestibular injury, manifesting as disequilibrium and oscillopsia.