ABSTRACT
The most frequently reported adverse reactions associated with aminoglycoside administration are ototoxicity manifested by hearing loss or vestibular dysfunction, neuromuscular blockade, and renal dysfunction. Factors associated with the risk of ototoxicity from amikacin were found to include total dose and previous therapy with an aminoglycoside antibiotic. The development of hearing loss with the concomitant use of a loop diuretic, ethacrynic acid or furosemide, and an aminoglycoside antibiotic is unique because it is the only situation where a single dose of an aminoglycoside antibiotic may be associated with deafness. The ranking of the ototoxic potential of the aminoglycoside antibiotics in humans is difficult because patient groups from study to study vary in the frequency of risk factors. Animal studies confirm the clinical findings that the ototoxic effect of aminoglycoside antibiotics is enhanced when given together with a loop diuretic, ethacrynic acid or furosemide.
