Antibiotic Toxicity to Kidneys and Hearing System (Ototoxicity)
Gentamicin and other drugs in the aminoclycoside family of antibiotics can cause damage to the hearing system (ototoxicity) and to the kidneys (nephrotoxicity) with misuse and overuse. A medical malpractice investigation can be a good idea for any patient who has suffered significant permanent damage.
When the hearing system is affected, the injury can include debilitating bouts of dizziness (vertigo), loss of hearing, oscillopsia (bouncing vision) and related symptoms.
The aminoglycoside family includes: gentamicin, tobramycin, neomycin (the oldest), streptomycin and a number of others. This Wikipedia article has a list.
Medical studies have established which of the “mycin” drugs are most poisonous to the hearing system and the kidneys.
- For the kidneys, neomycin and gentamicin are the most toxic and streptomycin the least toxic.
- For the hearing system, gentamicin and tobramycin are the most notorious for causing damage to the cochlea (inner ear) or to the vestibular system, which gives patients vertigo.
Preventive techniques to reduce the risk of toxicity from these drugs include:
- Once-daily dosing of the entire daily prescribed amount, instead of divided doses over the course of the day.
- Co-administration of NAC (n-Acetylcysteine) (the same drug used to treat Tylenol or acetaminophen poisoning).
- Choice of one of the less toxic drugs in this antibiotic family.
- Stopping the antibiotic if possible after a week to ten days. Most cases of antibiotic poisoning to the kidneys or hearing system are from prolonged treatment.
- If prolonged treatment is necessary, monitoring the patient’s hearing regularly is important.
- Careful doctors also usually monitor the patient’s blood levels of the antibiotic and do regular testing for kidney function while an aminoglycoside antibiotic is being administered.
A troubling sign of potential misuse and medical malpractice is when these drugs are used by general practice doctors who have failed to call in an infectious disease specialist to help them with techniques to reduce the risk of ototoxicity (hearing system damage) and nephrotoxicity (kidney damage). Often the culture and sensitivity test will show that a less toxic antibiotic would have worked against the infection.
Injuries to the middle and inner ear from these drugs can be quite disabling for normal life. Patients need a thorough evaluation by an ear-nose-throat specialist who specializes in the ears: a neuro-otologist. There are also physical therapists who specialize in helping patients with vestibular dysfunction. Sometimes a cochlear implant is recommended to restore some level of hearing.
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