title: Ototoxicity of ototopical antibiotic drops in humans.
abstract: OBJECTIVE
  We sought to determine the incidence of injury to the cochlea or vestibular system from the use of ototopic antibiotic ear drops.
  
  
  METHODS
  We conducted a MEDLINE search of the published literature from 1966 to the present using the search items of "ototopic antibiotics," "ototopic drops," "antibiotic resistance," and others to identify pertinent articles. These articles were reviewed and graded according to evidence quality. Forty-four articles were found; 27 articles were considered appropriate for review and 14 of these articles were thought to warrant further extensive review. The latter 14 articles dealt directly with the evaluation of either hearing loss or changes in vestibular function after the use of ototopic ear drops. We eliminated studies that did not consider hearing or vestibular function. We considered only articles in the English language, eliminating articles that not address the ototoxicity of ototopical ear drops.
  
  
  RESULTS
  Most of these articles were in the level 3 to 3b category. Two of the articles were in the 1b category, evaluating evidence-based studies. An article that reviewed case reports of ototopical ototoxicity and a survey article are included in this study, as case reports of ototopical ototoxicity and survey articles.
  
  
  CONCLUSIONS
  We found a total of 54 cases of gentamicin vestibular toxicity and, in 24 of these patients, cochlear toxicity was also documented. Our review also found 11 cases of cochlear and 2 cases of vestibular toxicity in neomycin-based ear drops.
authors.affiliation: Loyola University Medical Center, Chicago, IL 60611, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Matz
authors.forename: Leonard
authors.initials: L
authors.lastname: Rybak
authors.forename: Peter S
authors.initials: PS
authors.lastname: Roland
authors.forename: Maureen
authors.initials: M
authors.lastname: Hannley
authors.forename: Rick
authors.initials: R
authors.lastname: Friedman
authors.forename: Spiros
authors.initials: S
authors.lastname: Manolidis
authors.forename: Michael G
authors.initials: MG
authors.lastname: Stewart
authors.forename: Peter
authors.initials: P
authors.lastname: Weber
authors.forename: Fred
authors.initials: F
authors.lastname: Owens
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000633:toxicity*; D003051:Cochlea / Q000187:drug effects*; D005839:Gentamicins / Q000008:administration & dosage / Q000633:toxicity*; D034381:Hearing Loss / Q000175:diagnosis; D006801:Humans; D009355:Neomycin / Q000008:administration & dosage / Q000633:toxicity; D014724:Vestibular Function Tests; D014722:Vestibule, Labyrinth / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D009355:Neomycin