Gentamicin vestibulotoxicity with modern systemic dosing regimens: a prospective study using video-oculography

Smyth, Duncan; Mossman, Stuart; Weatherall, Mark; Jolliffe, Evan; Joshi, Purwa; Taylor, Jennifer; Thorne, Katie; Watson, Eloise; Leadbetter, Ruth; Mossman, Benjamin; Moss, Tawhai; Todd, Nicholas; Schneider, Erich

doi:10.1080/00016489.2019.1637935

Cited by 5 publications

(10 citation statements)

References 23 publications

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“…Notably, 20% of the treated patients in group B were evaluated by a neurotologist. This percentage may seem high compared to other studies [8], but some of them did not present altered vestibular function. They were studied, and therefore, were included in the study because they presented some symptoms, generally only instability.…”

Section: Discussioncontrasting

confidence: 59%

“…There are very few references in the literature about the importance of the participation and early intervention of a neurotologist in the progression of vestibulotoxicity produced by systemic gentamicin [8,14] and none related to the treatment of infective endocarditis.…”

Section: Discussionmentioning

confidence: 99%

“…Gentamicin can produce mild and early vestibulotoxicity (reversible and asymptomatic) in some patients [20]. Because of this, informing patients that the slightest symptom of imbalance should be reported and recommending routine vestibular testing are key to identifying vestibulotoxicity early and making a significant difference in the prognosis and development of permanent vestibular damage [8].…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms are usually mild at the beginning, which is why patients do not report them until they are severely affected; however, vestibulotoxicity occurs very quickly. A study reported that all affected patients (treated with gentamicin) were asymptomatic but presented vestibular abnormality within 3.5 h after administration of gentamicin [8].…”

Section: Discussionmentioning

confidence: 99%

“…This antibiotic produces bilateral 2 of 9 vestibular loss without vertigo [7]. Although it is usually bilateral and symmetric, it can also be unilateral [8].…”

Section: Introductionmentioning

confidence: 99%

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Prevention of Severe Vestibular Hypofunction after Systemic Gentamicin

Ferreira-Cendón

Martínez-Carranza

Fernandez-Nava

et al. 2022

JCM

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The importance of early evaluation by a neurotologist in patients with infective endocarditis treated with systemic gentamicin and its impact on the patients’ quality of life was evaluated. This is a longitudinal retrospective cohort study of 29 patients who received intravenous gentamicin for the treatment of infective endocarditis. Patients were classified into two groups: group A, before a neurotologist was included in the treatment protocol, and group B, after the inclusion of a neurotologist. The frequency of the different symptoms in each group was measured, and the gain of the vestibulo-ocular reflex (VOR) and its relationship with the presence of oscillopsia. In total, 13 and 16 patients were assigned to groups A and B, respectively. The mean gain of the VOR measured using the video head impulse test in group A was 0.44 in the best side and 0.39 in the worst side. In group B, the mean gain was 0.71 (best side) and 0.64 (worst side) (p < 0.0001). The patients who complained about oscillopsia had a main gain of 0.41 in the best side and 0.35 in the worst side. Evaluation of vestibular function should be included in the infective endocarditis treatment protocol, including the adverse effects of systemic gentamicin.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…This antibiotic produces bilateral 2 of 9 vestibular loss without vertigo [7]. Although it is usually bilateral and symmetric, it can also be unilateral [8].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevention of Severe Vestibular Hypofunction after Systemic Gentamicin

Ferreira-Cendón

Martínez-Carranza

Fernandez-Nava

et al. 2022

JCM

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Gentamicin

2019

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Bilateral Vestibular Failure May Improve With Treatment of the Underlying Condition

Smyth

Mossman²

2021

The Neurologist

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Introduction: Bilateral vestibular failure (BVF) is an uncommon condition with numerous etiologies. It causes chronic oscillopsia and imbalance and is usually irreversible. We report 2 cases of BVF due to unusual causes, both of which improved with treatment of the underlying condition.Case Reports: The first patient was a 39-year-old female who developed profound BVF due to neurosarcoidosis. She was started on steroids and azathioprine and her vestibular function gradually improved, with essentially normal function 4.5 years after starting treatment. The second patient was a 54-year-old female who developed BVF in the context of glucagonoma. After treatment with octreotide, her vestibular function improved to almost normal, and she thus met the criteria for a probable paraneoplastic syndrome.Conclusions: While BVF is usually permanent, this report demonstrates that some cases are likely to be reversible with treatment of the underlying cause. It is therefore imperative for clinicians to ensure that patients with BVF are thoroughly investigated.

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Gentamicin vestibulotoxicity with modern systemic dosing regimens: a prospective study using video-oculography

Cited by 5 publications

References 23 publications

Prevention of Severe Vestibular Hypofunction after Systemic Gentamicin

Prevention of Severe Vestibular Hypofunction after Systemic Gentamicin

Gentamicin

Bilateral Vestibular Failure May Improve With Treatment of the Underlying Condition

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