Gentamicin vestibulotoxicity with modern systemic dosing regimens : a prospective study using video-oculography
Objectives: To determine the incidence of gentamicin vestibulotoxicity with current dosing regimens, and to evaluate the feasibility of routine video-oculography on all patients given gentamicin. Materials and methods: In this prospective incidence study serial horizontal vestibulo-ocular reflex (HVOR) gain measurements were recorded using video-oculography on adult inpatients receiving intravenous gentamicin. The primary outcome was the proportion of patients developing impairment of their HVOR gain. Results: After exclusions, 42 patients were included in the analysis. Three patients (7.1%) developed asymptomatic vestibulotoxicity, exact 95% confidence interval 1.5-19.5%. In two of these patients the deficit resolved within several hours. No patients developed symptomatic vestibulotoxicity. There was no evidence for a generalised reduction in group HVOR gain with time. HVOR gain was not associated with total gentamicin dose, dynamic visual acuity or subjective imbalance. Conclusions and significance: Gentamicin may cause reversible, asymptomatic vestibulotoxicity. Video-oculography may be useful to monitor for vestibulotoxicity in patients treated with gentamcin; however, testing all patients routinely may be challenging.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:139 |
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| Enthalten in: |
Acta oto-laryngologica - 139(2019), 9 vom: 16. Sept., Seite 759-768 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Smyth, Duncan [VerfasserIn] |
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| Links: |
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| Themen: |
Aminoglycosides |
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| Anmerkungen: |
Date Completed 28.01.2020 Date Revised 28.01.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/00016489.2019.1637935 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM299242668 |
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| 500 | |a Date Revised 28.01.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Objectives: To determine the incidence of gentamicin vestibulotoxicity with current dosing regimens, and to evaluate the feasibility of routine video-oculography on all patients given gentamicin. Materials and methods: In this prospective incidence study serial horizontal vestibulo-ocular reflex (HVOR) gain measurements were recorded using video-oculography on adult inpatients receiving intravenous gentamicin. The primary outcome was the proportion of patients developing impairment of their HVOR gain. Results: After exclusions, 42 patients were included in the analysis. Three patients (7.1%) developed asymptomatic vestibulotoxicity, exact 95% confidence interval 1.5-19.5%. In two of these patients the deficit resolved within several hours. No patients developed symptomatic vestibulotoxicity. There was no evidence for a generalised reduction in group HVOR gain with time. HVOR gain was not associated with total gentamicin dose, dynamic visual acuity or subjective imbalance. Conclusions and significance: Gentamicin may cause reversible, asymptomatic vestibulotoxicity. Video-oculography may be useful to monitor for vestibulotoxicity in patients treated with gentamcin; however, testing all patients routinely may be challenging | ||
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| 650 | 4 | |a vestibulotoxicity | |
| 650 | 4 | |a video head impulse testing | |
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| 700 | 1 | |a Weatherall, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Jolliffe, Evan |e verfasserin |4 aut | |
| 700 | 1 | |a Joshi, Purwa |e verfasserin |4 aut | |
| 700 | 1 | |a Taylor, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Thorne, Katie |e verfasserin |4 aut | |
| 700 | 1 | |a Watson, Eloise |e verfasserin |4 aut | |
| 700 | 1 | |a Leadbetter, Ruth |e verfasserin |4 aut | |
| 700 | 1 | |a Mossman, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Moss, Tawhai |e verfasserin |4 aut | |
| 700 | 1 | |a Todd, Nicholas |e verfasserin |4 aut | |
| 700 | 1 | |a Schneider, Erich |e verfasserin |4 aut | |
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