[Aminoglycosides, their ototoxic effect]

The aminoglycosides are broad-spectrum antibiotics especially effective against many strains of gramnegative bacteria. Since streptomycin was used for tuberculosis treatment, the toxic side effects of such antibiotics were identified. The kidney and the inner ear are affected. The nephrotoxicity is usually reversible, while the chronic ototoxicity is irreversible. Within the inner ear, it is the cochlear and vestibular sensory epithelium that is damaged. A toxic mechanism in which an interference with mitochondrial protein synthesis is central has been inferred. During the last fifty years, risk factors for aminoglycoside-induced-ototoxicity have been identified, including a genetically transmitted hypersensitivity to the ototoxic effect. Although several strategies to prevent the damage have been proposed, today it is not rare that patients suffer permanent loss of hearing and loss of balance due to aminoglycoside toxicity. This review gives a brief background of aminoglycoside ototoxicity, some strategies to prevent it, and the therapeutic use of the vestibulo-toxic effect.