title: Are gentamicin and/or vancomycin associated with ototoxicity in the neonate? A retrospective audit.
abstract: BACKGROUND
  Aminoglycoside-induced ototoxicity has been reported in neonates but its incidence is poorly defined, whereas vancomycin-induced ototoxicity has not been reported in neonates.
  
  
  OBJECTIVE
  To compare hearing test results in infants in a neonatal intensive care unit (NICU) who were or were not treated with extended interval gentamicin dosing and/or standard vancomycin dosing.
  
  
  METHODS
  A database of otoacoustic emissions (OAE), over a 5-year period of NICU admissions, was combined with databases of gentamicin and vancomycin dosing to compare patients treated or not treated with these antibiotics.
  
  
  RESULTS
  A total of 2,347 OAE results was available. OAE failure rates were: no gentamicin and no vancomycin (noGnoV), 7% (85/1,233); gentamicin but no vancomycin (GnoV), 4% (42/949); vancomycin but no gentamicin (VnoG), 22% (9/41) and gentamicin and vancomycin (GandV), 14% (17/124). Compared to noGnoV there was a decreased risk of OAE failure in GnoV (p = 0.022, OR 0.64, 95% CI 0.44-0.94) and an increased risk in VnoG (p = 0.003, OR 3.46, 95% CI 1.54-7.75) and GandV, (p = 0.006, OR 2.20, 95% CI 1.26-3.83).
  
  
  CONCLUSIONS
  Gentamicin, as used and evaluated in this audit, showed no evidence of an increased risk of ototoxicity; what was observed was a statistically significant decrease in OAE failure rate. Vancomycin, by contrast, was associated with ototoxicity.
authors: Department of Clinical Pharmacology, Christchurch Hospital, Christchurch, New Zealand. janevb@cdhb.govt.nz
authors: Jane W A
authors: JW
authors: Vella-Brincat
authors: Evan J
authors: EJ
authors: Begg
authors: Barbara J
authors: BJ
authors: Robertshawe
authors: Adrienne M
authors: AM
authors: Lynn
authors: Tracey L
authors: TL
authors: Borrie
authors: Brian A
authors: BA
authors: Darlow
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D054869:Clinical Audit; D003054:Cochlear Implants; D004305:Dose-Response Relationship, Drug; D005839:Gentamicins / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D034381:Hearing Loss / Q000139:chemically induced* / Q000453:epidemiology* / Q000628:therapy; D006320:Hearing Tests; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy; D014640:Vancomycin / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014640:Vancomycin