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Gentamicin ototoxicity in continuous ambulatory peritoneal dialysis

Published online by Cambridge University Press:  29 June 2007

B. S. Gendeh ,
H. Said ,
A. G. Gibb ,
N. S. Aziz ,
N. Kong  and
Z. M. Zahir
B. S. Gendeh*
Affiliation:
Department of ENT, National University of Malaysia (NUM)
H. Said
Affiliation:
Department of ENT, National University of Malaysia (NUM)
A. G. Gibb
Affiliation:
Department of Otorhinolaryngology, National University Hospital, Singapore
N. S. Aziz
Affiliation:
Department of Pharmacology, National University of Malaysia (NUM)
N. Kong
Affiliation:
Department of Nephrology, National University of Malaysia (NUM)
Z. M. Zahir
Affiliation:
Department of Nephrology, General Hospital, Kuala Lumpar.
*
Dr B. S. Gendeh, Research Register, ENT Department, North Riding Infirmary, Newport Road, Middlesborough, Cleveland, TS1 5JE, UK.
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Abstarct

A prospective study was undertaken of 10 chronic renal failure patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) complicated by repeated bouts of peritonitis treated with gentamicin. Each 10-day treatment course consisted of a 120 mg loading dose, followed by 16 mg in 21 of peritoneal dialysate, given four times a day. Serum gentamicin analysed by enzyme immunoassay showed a mean level of 5.2 µg/ml, (range 3.7 to 6.6 µg/ml) four hours after the loading dose. Similar levels, well within the therapeutic range, were maintained on the 3rd, 5th, 7th and 9th days of intraperitoneal gentamicin therapy, suggesting no accumulation of gentamicin in the serum. Pure tone audiometry, electronystagmography and clinical assessment were performed during each course of treatment. Although no evidence of ototoxicity was found during the first two courses of gentamicin, but disequilibrium and bobbing oscillopsia were present during the third and fourth courses of gentamicin. These findings could be explained by cumulative injury to the vestibular apparatus caused by repeated therapeutic insults.

Keywords

Peritoneal dialysiscontinuous ambulatoryKidney failurechronicGentamicinsototoxicity
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 8 , August 1993 , pp. 681 - 685
Copyright
Copyright © JLO (1984) Limited 1993

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