Clinical monitoring of the effects of gentamicin by electrocochleography.
Eight patients receiving prolonged treatment with gentamicin for bacterial endocarditis were monitored for possible ototoxicity using transtympanic electrocochleography as an adjunct to pure tone audiometry, vestibular function tests and serum gentamicin levels. An immediate effect of intravenous gentamicin on the cochlea, shown by changes in the whole nerve action potential and/or cochlear microphonic was recorded in seven patients, none of whom had experienced vestibular or auditory symptoms with gentamicin prior to testing. Two patients subsequently developed evidence of vestibular dysfunction, and a high frequency sensorineural hearing loss occurred in a third individual. There have been no previous report of the immediate effects of gentamicin on the human cochlea to date. The significance of these findings in routine clinical monitoring of ototoxicity is discussed in the light of clinical and animal evidence for the possible mode of action of aminoglycosides on the auditory and vestibular apparatus.
D000200:Action Potentials / Q000187:drug effects; D000328:Adult; D001299:Audiometry; D001300:Audiometry, Evoked Response; D001301:Audiometry, Pure-Tone; D003055:Cochlear Microphonic Potentials / Q000187:drug effects; D004697:Endocarditis, Bacterial / Q000188:drug therapy; D005260:Female; D005839:Gentamicins / Q000009:adverse effects* / Q000097:blood; D006311:Hearing Disorders / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014724:Vestibular Function Tests
D005839:Gentamicins