Summary
The ototoxic effect of plasma-level-controlled netilmicin and tobramycin was monitored in 20 intensive care patients, using auditory brainstem responses (ABRs). ABRs were recorded at the onset and after 6 days of treatment. Significant shifts in the ABR wave V latency were observed independent of the type of medication received or whether the patients were intubated or not. Shifts were also observed in wave I latencies. These latter changes were only significant for the complete population, probably because this potential is more difficult to elicit and measure than is wave V. The I–V interlatency time was greater for netilmicin than for tobramycin. These results indicate that the cumulative effects of aminoglycoside ototoxicity may be different for the central and peripheral nervous systems, and therefore ABR measurements may be the most accurate way of controlling ototoxicity in intensive care patients.
Similar content being viewed by others
References
Adelman C, Linder N, Levi H (1989) Auditory nerve and brainstem evoked response thresholds in infants treated with gentamicin as neonates. Ann Otol Rhinol Laryngol 98:1989
Bernard PA, Péehère JC, Hébert R (1980) Altered objective audiometry in aminoglycoside-treated human neonates. Arch otorhinolarnygol 228:205–210
Buring JE, Evans DA, Mayrent SL, Rosner B, Colton T, Hennekens CH (1988) Randomized trials of aminoglycoside antibiotics: quantitative overview. Rev Infect Dis 10: 951–957
Chiappa KH, Harrison JL, Brooks EB, Young RR (1980) Brainstem auditory evoked responses in 200 patients with multiple sclerosis. Ann Neurol 7:135–143
Fee WE (1980) Aminoglycoside ototoxicity in the human. Laryngoscope 90 [Suppl 24]:1–19
Guerit JM, Mahieu P (1981) The influence of ototoxic drugs on brainstem auditory evoked potentials in man. Arch Otorhinolaryngol 233:189–199
Hall JW III, Mackey-Hargadine J, Allen SJ (1985) Monitoring neurologic status of comatose patients in the intensive care unit. In: Jacobsen JT (ed) The auditory brainstem response (chap. 14). Taylor and Francis, London
Henley CM, Schacht J (1988) Pharmacokinetics of aminoglycoside antibiotics in blood, inner ear fluids and tissues and their relationship to ototoxicity. Audiology 27:137–146
Huizing EH, De Groot JCMJ (1987) Human cochlear pathology in aminoglycoside ototoxicity. Acta Otolaryngol (Stockh) [Suppl 436]:117–125
Jerger J, Maudlin L (1978) Prediction of sensorineural hearing loss from the brainstem evoked response. Arch Otolaryngol 104:456–461
Keith WJ, Greville KA (1987) Effects of audiometric configuration on the auditory brainstem response. Ear Hear 8:49–55
Pick J, Lumenta C, Bock WJ (1985) Ueberwachung der Gehörfunktion komatöser Patienten unter der Therapie mit potentiell ototoxischen Substanzen mittels akustisch evozierter Hirnstammpotentiale. Andsth Intensivther Notfallmed 20: 1–5 13.
Probst R, Lonsbury-Martin BL, Martin GK, Coats AC (1987) Otoacoustic emissions in ears with hearing loss. Am J Otolaryngol 8:73–81
Schwarz G, Pfurtscheller G, List WF (1986) Akustisch evozierte Hirnstammpotentiale —Möglichkeiten und Probleme an der Intensivstation. Anästh Intensivther Notfallmed 21:262–265
Siegenthaler WE, Bonetti A, Luethy R (1986) Aminoglycoside antibiotics in infectious diseases. Am J Med 80 [Suppl 6B] 2–14
Toshiaki Y, Shunkichi B (1983) Evaluation of brain-stem function by the auditory brain-stem response and the caloric vestibular reaction in comatose patients. Arch Otorhinolaryngol 238:33–43
Wenk M, Vozeh S, Follath F (1984) Serum level monitoring of antibacterial drugs. Clin Pharmacokinet 9:475–492
Wilson P, Ramsden RT (1977) Immediate effects of tobramycin on human cochlea and correlation with serum tobramycin levels. Br Med J 1: 259–261
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hotz, M.A., Allum, J.H.J., Kaufmann, G. et al. Shifts in auditory brainstem response latencies following plasma-level-controlled aminoglycoside therapy. Eur Arch Otorhinolaryngol 247, 202–205 (1990). https://doi.org/10.1007/BF00178984
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00178984