{"title":"Ototoxic Drug Exposure and Hearing Loss in Neonates: A Scoping Review.","authors":"Subaasri Rameshsankar, Jayashree Seethapathy, Umamaheshwari Balakrishnan","doi":"10.1044/2024_AJA-24-00065","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This scoping review aims to map the effects of dosage levels, dosage intervals, duration of exposure, and serum concentration levels of gentamicin, amikacin, vancomycin, furosemide, and bumetanide on newborn hearing.</p><p><strong>Method: </strong>Using PubMed, Scopus, and Ovid databases (January 2010-2022), a scoping review was conducted to identify studies on ototoxic drug exposure in neonates. The review included articles that described details on ototoxic drug exposure and hearing status, dosage levels, duration of exposure, and serum concentration levels. The search results were summarized using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.</p><p><strong>Results: </strong>Out of 4,395 entries, 28 were selected for inclusion in the scoping review. The studies were separated according to the exposed drugs: gentamicin, amikacin, vancomycin, furosemide, bumetanide, and a combination of drugs. Four out of five studies on amikacin exposure revealed an increased association with ototoxicity and abnormal trough levels. Six of seven studies on gentamicin exposure reported elevated trough concentration levels in a small number of infants, but no studies reported hearing loss. Two out of four studies on vancomycin exposure reported a dose-dependent risk for infants to develop hearing loss.</p><p><strong>Conclusions: </strong>Gentamicin exposure in neonates has been extensively studied and considered relatively safe, except in cases of elevated peak or trough concentration levels. Amikacin exposure was reported to be more ototoxic, as the elevation of trough concentration levels was associated with refer results in hearing. Loop-diuretic exposure demonstrated a significant ototoxic effect. When used with other ototoxic medications, vancomycin is said to have a greater effect on ototoxicity.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.26814700.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-22"},"PeriodicalIF":1.4000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Audiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2024_AJA-24-00065","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This scoping review aims to map the effects of dosage levels, dosage intervals, duration of exposure, and serum concentration levels of gentamicin, amikacin, vancomycin, furosemide, and bumetanide on newborn hearing.
Method: Using PubMed, Scopus, and Ovid databases (January 2010-2022), a scoping review was conducted to identify studies on ototoxic drug exposure in neonates. The review included articles that described details on ototoxic drug exposure and hearing status, dosage levels, duration of exposure, and serum concentration levels. The search results were summarized using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
Results: Out of 4,395 entries, 28 were selected for inclusion in the scoping review. The studies were separated according to the exposed drugs: gentamicin, amikacin, vancomycin, furosemide, bumetanide, and a combination of drugs. Four out of five studies on amikacin exposure revealed an increased association with ototoxicity and abnormal trough levels. Six of seven studies on gentamicin exposure reported elevated trough concentration levels in a small number of infants, but no studies reported hearing loss. Two out of four studies on vancomycin exposure reported a dose-dependent risk for infants to develop hearing loss.
Conclusions: Gentamicin exposure in neonates has been extensively studied and considered relatively safe, except in cases of elevated peak or trough concentration levels. Amikacin exposure was reported to be more ototoxic, as the elevation of trough concentration levels was associated with refer results in hearing. Loop-diuretic exposure demonstrated a significant ototoxic effect. When used with other ototoxic medications, vancomycin is said to have a greater effect on ototoxicity.
期刊介绍：
Mission: AJA publishes peer-reviewed research and other scholarly articles pertaining to clinical audiology methods and issues, and serves as an outlet for discussion of related professional and educational issues and ideas. The journal is an international outlet for research on clinical research pertaining to screening, diagnosis, management and outcomes of hearing and balance disorders as well as the etiologies and characteristics of these disorders. The clinical orientation of the journal allows for the publication of reports on audiology as implemented nationally and internationally, including novel clinical procedures, approaches, and cases. AJA seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of clinical audiology, including audiologic/aural rehabilitation; balance and balance disorders; cultural and linguistic diversity; detection, diagnosis, prevention, habilitation, rehabilitation, and monitoring of hearing loss; hearing aids, cochlear implants, and hearing-assistive technology; hearing disorders; lifespan perspectives on auditory function; speech perception; and tinnitus.
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