ABSTRACT
The aminoglycosides are associated with ototoxic reactions exclusively in the inner ear, which may result in either vestibular damage and present with vertigo, nausea, vomiting, nystagmus, and ataxia, or cochlear damage in cases of severe intoxication, elevation of thresholds at most frequencies. The aminoglycosides are eliminated from the body via the kidneys almost exclusively by glomercular filtration. The pharmacokinetics of gentamicin, tobramycin, netilmicin, and sisomicin appear to be very similar, while kanamycin and amikacin may be grouped together separately from the rest. The application of aminoglycoside antibiotics to the tympanic cavity may well give rise to accumulation of significant levels of aminoglycosides in the cochlea fluids and this has been particularly well recognized in experimental animals with the observed loss of outer hair cells, particularly at the basal turn of the cochlea. There is abundant evidence of an interaction between the aminoglycoside antibiotics and loop diuretics both clinically and experimentally.
