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The Incidence of Aminoglycoside Antibiotic-Induced Hearing Loss

The Incidence of Aminoglycoside Antibiotic-Induced Hearing Loss Abstract • The definition of ototoxicity in most clinical studies of aminoglycoside antibiotics is an increase in pure-tone threshold from a baseline audiogram ≥ 15 dB at two or more frequencies, or ≥20 dB at one or more frequencies. In this study, test-retest auditory threshold differences of this magnitude were found in a group of 20 normal volunteers who were not taking any known ototoxic drugs. Depending on which of the two criteria for ototoxicity are used, these data represent a 20% or 33% incidence of ototoxicity. We believe that many of the audiometric changes reported to represent aminoglycoside antibiotic ototoxicity may actually represent the normal test-retest variability of pure-tone audiometry. If this is true, the reported incidence of hearing loss due to aminoglycoside antibiotics may be exaggerated. (Arch Otolaryngol Head Neck Surg. 1990;116:406-410) References 1. Brummett RE, Fox KE. Aminoglycoside ototoxicity in animal models . In: Whelton A, Neu HC, eds. The Aminoglycosides: Microbiology, Clinical Use, and Toxicology . New York, NY: Marcel Dekker Inc; 1982:419-451. 2. Bendush CL. Ototoxicity: clinical consideration and comparative information . In: Whelton A, Neu HC, eds. The Aminoglycosides: Microbiology, Clinical Use, and Toxicology . New York, NY: Marcel Dekker Inc; 1982:453-486. 3. Apgar DA. Comment on aminoglycoside evaluation . Drug Intell Clin Pharm . 1982;16:956-961. 4. Hinshaw HC, Feldman WH. Streptomycin in treatment of clinical tuberculosis: a preliminary report . Mayo Clin Proc. 1945;20:313. 5. Kries B. Kanamycin toxicity in adults . Ann NY Acad Sci. 1966;132:957-967.Crossref 6. Brouet FJ, Marche J, Chevallier J, et al. Etude experimentale et clinique de la kanamycine dans l'infection tuberculeuse . Rev Tuberc Pneumol Paris. 1959;23:44-100. 7. Royster JD, Royster LH. Adopting a scheme for identifying significant threshold shifts . In: Gasaway DC, ed. Hearing Conservation . Englewood Cliffs, NJ: Prentice-Hall International Inc; 1985:257-317. 8. Royster JD, Royster LH. Audiometric data base analysis . In: Berger EH, Ward WD, Morrill JC, et al, eds. Noise and Hearing Conservation Manual . New York, NY: American Industrial Hygiene Association; 1986:293-317. 9. Witting EG, Hughson W. Inherent accuracy of a series of repeated clinical audiograms . Laryngoscope . 1940;50:259-269.Crossref 10. Atherly GR, Dingwall-Fordyce I. The reliability of repeated auditory threshold determination . Br J Ind Med. 1963;20:231-235. 11. Pelmear PL, Hughes BJ. Self-recording audiometry in industry . Br J Ind Med. 1974;31:304-309. 12. Bryan ME, Parbook HD, Tempest W. A note on quiet threshold shift in the absence of noise . J Sound Vibr. 1965;2:147-149.Crossref 13. Bryan ME. Industrial audiometry . In: Stephens SDG, ed. Disorders of Auditory Function II . Orlando, Fla: Academic Press Inc; 1976. 14. Lerner SA, Seligsohn R, Matz GJ. Comparative clinical studies of ototoxicity and nephrotoxicity of amikacin and gentamicin . Am J Med. 1977;62:919-923.Crossref 15. Fee WE Jr, Vierra V, Lathrop GR. Clinical evaluation of aminoglycoside toxicity: tobramycin versus gentamicin, a preliminary report . J Antimicrob Chemother . 1978;4( (suppl A) ):31-36.Crossref 16. Davey PG, Jabeen FJ, Harpur ES, et al. The use of pure-tone audiometry in the assessment of gentamicin auditory toxicity . Br J Audiol. 1982; 16:151-154.Crossref 17. Davey PG, Jabeen FJ, Harpur ES, et al. A controlled study of the reliability of pure-tone audiometry for the detection of gentamicin auditory toxicity . J Laryngol Otol. 1983;97:27-36.Crossref 18. Worning AM, Frimodt-Moller N, Ostri P, et al. Antibiotic prophylaxis in vascular reconstructive surgery: a double-blind placebo-controlled study . J Antimicrob Chemother . 1986;17:105-113.Crossref 19. Smith CR, Ambinder R, Lipsky JJ, et al. Cefotaxime compared with nafcillin plus tobramycin for serious bacterial infections . Ann Intern Med. 1984;101:469-477.Crossref 20. Smith CR. Review of studies evaluating the pathophysiological effects of aminoglycosides in normal human volunteers . In: Periti P, Grassi G, eds. Current Chemotherapy and Immunotherapy: Proceedings of the 12th International Congress of Chemotherapy . Washington, DC: The American Society for Microbiology; 1981;2. 21. American National Standards Specifications for Audiometers: ANSI S3.6-1969 . New York, NY: American National Standards Institute; 1970. 22. American Speech and Hearing Association. guidelines for manual pure-tone threshold audiometry . J Am Speech Lang Hear Assoc. 1978; 20:297-301. 23. Erlandsson B, Hakanson H, Ivarsson A, Nilsson P. The reliability of Bekesy sweep audiometry recording and effects of the earphone position . Acta Otolaryngol Stockh . 1980;suppl 336:99-112.Crossref 24. Woodford C. The effect of small changes in frequency on clinically determined estimates of auditory threshold . J Am Speech Lang Hear Assoc. 1984;26:25-30. 25. Dobie RA. Reliability and validity of industrial audiometry: implications for hearing conservation program design . Laryngoscope . 1983; 93:906-927.Crossref 26. Guay DRP. Netilmicin (Netromycin, Schering-Plough) . Drug Intell Clin Pharm . 1983;17:83-91. 27. Morrill JC. Audiometric testing: review of audiograms and worker referral . Occup Health Saf. 1984;53:64-67. 28. Hipskind MN, Rintelmann WF. Effects of experimenter bias upon pure-tone and speech audiometry . J Aud Res. 1969;9:298-305. 29. Mets JT. Reliability of industrial audiometry as a screening method for incipient noise-induced hearing loss . S Afr Med J. 1987;71:35-39. 30. Lamore PJ, Verweij C, Brocaar MP. Reliability of auditory function tests in severely hearing-impaired and deaf subjects . Audiology . 1984;23:453-466.Crossref 31. Dancer J, Ventry I, Hill MW. Effects of stimulus presentation and instructions on pure-tone thresholds and false-alarm responses . J Speech Hear Disord . 1976;61:315-324. 32. Hickling S. Studies on the reliability of auditory threshold values . J Aud Res. 1966;6:39-46. 33. Brummett RE. Drug induced ototoxicity . Drugs. 1980;19:412-428.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

The Incidence of Aminoglycoside Antibiotic-Induced Hearing Loss

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References (35)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1990.01870040028008
Publisher site
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Abstract

Abstract • The definition of ototoxicity in most clinical studies of aminoglycoside antibiotics is an increase in pure-tone threshold from a baseline audiogram ≥ 15 dB at two or more frequencies, or ≥20 dB at one or more frequencies. In this study, test-retest auditory threshold differences of this magnitude were found in a group of 20 normal volunteers who were not taking any known ototoxic drugs. Depending on which of the two criteria for ototoxicity are used, these data represent a 20% or 33% incidence of ototoxicity. We believe that many of the audiometric changes reported to represent aminoglycoside antibiotic ototoxicity may actually represent the normal test-retest variability of pure-tone audiometry. If this is true, the reported incidence of hearing loss due to aminoglycoside antibiotics may be exaggerated. (Arch Otolaryngol Head Neck Surg. 1990;116:406-410) References 1. Brummett RE, Fox KE. Aminoglycoside ototoxicity in animal models . In: Whelton A, Neu HC, eds. The Aminoglycosides: Microbiology, Clinical Use, and Toxicology . New York, NY: Marcel Dekker Inc; 1982:419-451. 2. Bendush CL. Ototoxicity: clinical consideration and comparative information . In: Whelton A, Neu HC, eds. The Aminoglycosides: Microbiology, Clinical Use, and Toxicology . New York, NY: Marcel Dekker Inc; 1982:453-486. 3. Apgar DA. Comment on aminoglycoside evaluation . Drug Intell Clin Pharm . 1982;16:956-961. 4. Hinshaw HC, Feldman WH. Streptomycin in treatment of clinical tuberculosis: a preliminary report . Mayo Clin Proc. 1945;20:313. 5. Kries B. Kanamycin toxicity in adults . Ann NY Acad Sci. 1966;132:957-967.Crossref 6. Brouet FJ, Marche J, Chevallier J, et al. Etude experimentale et clinique de la kanamycine dans l'infection tuberculeuse . Rev Tuberc Pneumol Paris. 1959;23:44-100. 7. Royster JD, Royster LH. Adopting a scheme for identifying significant threshold shifts . In: Gasaway DC, ed. Hearing Conservation . Englewood Cliffs, NJ: Prentice-Hall International Inc; 1985:257-317. 8. Royster JD, Royster LH. Audiometric data base analysis . In: Berger EH, Ward WD, Morrill JC, et al, eds. Noise and Hearing Conservation Manual . New York, NY: American Industrial Hygiene Association; 1986:293-317. 9. Witting EG, Hughson W. Inherent accuracy of a series of repeated clinical audiograms . Laryngoscope . 1940;50:259-269.Crossref 10. Atherly GR, Dingwall-Fordyce I. The reliability of repeated auditory threshold determination . Br J Ind Med. 1963;20:231-235. 11. Pelmear PL, Hughes BJ. Self-recording audiometry in industry . Br J Ind Med. 1974;31:304-309. 12. Bryan ME, Parbook HD, Tempest W. A note on quiet threshold shift in the absence of noise . J Sound Vibr. 1965;2:147-149.Crossref 13. Bryan ME. Industrial audiometry . In: Stephens SDG, ed. Disorders of Auditory Function II . Orlando, Fla: Academic Press Inc; 1976. 14. Lerner SA, Seligsohn R, Matz GJ. Comparative clinical studies of ototoxicity and nephrotoxicity of amikacin and gentamicin . Am J Med. 1977;62:919-923.Crossref 15. Fee WE Jr, Vierra V, Lathrop GR. Clinical evaluation of aminoglycoside toxicity: tobramycin versus gentamicin, a preliminary report . J Antimicrob Chemother . 1978;4( (suppl A) ):31-36.Crossref 16. Davey PG, Jabeen FJ, Harpur ES, et al. The use of pure-tone audiometry in the assessment of gentamicin auditory toxicity . Br J Audiol. 1982; 16:151-154.Crossref 17. Davey PG, Jabeen FJ, Harpur ES, et al. A controlled study of the reliability of pure-tone audiometry for the detection of gentamicin auditory toxicity . J Laryngol Otol. 1983;97:27-36.Crossref 18. Worning AM, Frimodt-Moller N, Ostri P, et al. Antibiotic prophylaxis in vascular reconstructive surgery: a double-blind placebo-controlled study . J Antimicrob Chemother . 1986;17:105-113.Crossref 19. Smith CR, Ambinder R, Lipsky JJ, et al. Cefotaxime compared with nafcillin plus tobramycin for serious bacterial infections . Ann Intern Med. 1984;101:469-477.Crossref 20. Smith CR. Review of studies evaluating the pathophysiological effects of aminoglycosides in normal human volunteers . In: Periti P, Grassi G, eds. Current Chemotherapy and Immunotherapy: Proceedings of the 12th International Congress of Chemotherapy . Washington, DC: The American Society for Microbiology; 1981;2. 21. American National Standards Specifications for Audiometers: ANSI S3.6-1969 . New York, NY: American National Standards Institute; 1970. 22. American Speech and Hearing Association. guidelines for manual pure-tone threshold audiometry . J Am Speech Lang Hear Assoc. 1978; 20:297-301. 23. Erlandsson B, Hakanson H, Ivarsson A, Nilsson P. The reliability of Bekesy sweep audiometry recording and effects of the earphone position . Acta Otolaryngol Stockh . 1980;suppl 336:99-112.Crossref 24. Woodford C. The effect of small changes in frequency on clinically determined estimates of auditory threshold . J Am Speech Lang Hear Assoc. 1984;26:25-30. 25. Dobie RA. Reliability and validity of industrial audiometry: implications for hearing conservation program design . Laryngoscope . 1983; 93:906-927.Crossref 26. Guay DRP. Netilmicin (Netromycin, Schering-Plough) . Drug Intell Clin Pharm . 1983;17:83-91. 27. Morrill JC. Audiometric testing: review of audiograms and worker referral . Occup Health Saf. 1984;53:64-67. 28. Hipskind MN, Rintelmann WF. Effects of experimenter bias upon pure-tone and speech audiometry . J Aud Res. 1969;9:298-305. 29. Mets JT. Reliability of industrial audiometry as a screening method for incipient noise-induced hearing loss . S Afr Med J. 1987;71:35-39. 30. Lamore PJ, Verweij C, Brocaar MP. Reliability of auditory function tests in severely hearing-impaired and deaf subjects . Audiology . 1984;23:453-466.Crossref 31. Dancer J, Ventry I, Hill MW. Effects of stimulus presentation and instructions on pure-tone thresholds and false-alarm responses . J Speech Hear Disord . 1976;61:315-324. 32. Hickling S. Studies on the reliability of auditory threshold values . J Aud Res. 1966;6:39-46. 33. Brummett RE. Drug induced ototoxicity . Drugs. 1980;19:412-428.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Apr 1, 1990

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