Newborn hearing screening: tobramycin and vancomycin are not risk factors for hearing loss.
OBJECTIVE
To investigate the chance of detecting hearing loss with neonatal hearing screening in relation to exposure to tobramycin and vancomycin.


METHODS
Automated auditory brainstem response (A-ABR) hearing screening was performed in all neonates with at least one risk factor. Data on drug administration were abstracted from patient files. Exposure to these drugs was related to the result of hearing screening. In patients failing hearing screening, exposure to ototoxic medication was assessed in the light of other risk factors for hearing loss.


RESULTS
Six hundred twenty-five patients were analyzed; 45 neonates failed hearing screening. Tobramycin, vancomycin, and furosemide were used in 508, 130, and 174 patients, respectively. Exposure to vancomycin, tobramycin, or furosemide or a combination, defined in terms of treatment duration, total dose, or serum concentrations of antibiotics, was not related to failure to pass A-ABR screening. Ototoxic medication was not the most probable risk factor in any of the patients with serum concentrations outside the therapeutic range.


CONCLUSIONS
Routine therapeutic drug monitoring of vancomycin and tobramycin in neonates for ototoxicity reasons is not helpful in detecting patients at risk for clinically important hearing loss in the 2- to 4-kHz range. A longer period of audiometric follow-up is needed to determine any long-term effects.
de Hoog
Matthijs
M
Department of Pediatrics, Erasmus University, Rotterdam, The Netherlands.
van Zanten
Bert A
BA
Hop
Wim C
WC
Overbosch
Ellen
E
Weisglas-Kuperus
Nynke
N
van den Anker
John N
JN
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001299:Audiometry; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016057:Evoked Potentials, Auditory, Brain Stem; D034381:Hearing Loss / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening; D012307:Risk Factors; D014031:Tobramycin / Q000008:administration & dosage / Q000009:adverse effects*; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D014031:Tobramycin