A pilot study on the use of amikacin in neonates: Who should be monitored for ototoxicity?

Engler, Deirdré; Schellack, Natalie; Naudé, Alida; Gous, A. G. S. Prof.

doi:10.1080/23120053.2015.1074432

Cited by 3 publications

(5 citation statements)

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“…Based on the results of our study and those of Engler et al, [6,15] ototoxicity is more likely to occur at high trough values (≥10 μg/mL). No significant effect was observed when the peak and trough values were compared between groups with and without ototoxicity (Table 3).…”

Section: (100%) Nssupporting

confidence: 81%

“…Neonates with incredibly immature renal function at GA < 34 weeks and with a low BW < 1000 g, are likely to accumulate high AMK levels. [15,25] The relative distribution volume of AG tends to be larger in neonates with BW < 1000 g; hence, a high dose is necessary to reach the peak value for therapeutically effective concentration. If such dosing occurs, the dosing interval should be extended to prevent side effects.…”

Section: Discussionmentioning

confidence: 99%

“…[ 14 ] The acceptable trough level of AMK in newborns is up to 10 μg/mL. [ 6 ] The risk of ototoxicity increases at trough levels above 10 μg/mL. [ 15 ] The ototoxicity caused by AGs depends on administration duration and total dose.…”

Section: Introductionmentioning

confidence: 99%

“…AGs cause nephrotoxicity and ototoxicity depending on the high concentration transition and time of exposure. [ 5 , 6 ] We focused on the two administration regimens’ side effects, especially nephrotoxicity and ototoxicity.…”

Section: Introductionmentioning

confidence: 99%

“…Side effects, such as nephrotoxicity, which depend on trough levels, have been reported. [5,6] Therefore, once-daily (OD) dosing has been common rather than multiple daily dosing, thereby making therapeutic drug monitoring (TDM) essential for AGs to ensure therapeutic efficacy and prevent toxicity. [7] Standard dosing of 15 mg/kg OD in neonates provides an effective amikacin (AMK) concentration (peak value) of 20 to 40 μg/mL.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of nephrotoxicity and ototoxicity following amikacin administration once daily or every 48 hours in neonates

et al. 2022

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The purpose of this study was to evaluate the effects of once daily (OD) or every 48 hours (every-48-h) administration of amikacin (AMK) on renal function and ototoxicity in neonates. We investigated the frequency of nephrotoxicity and ototoxicity in neonates who received AMK OD or every-48-h from April 2015 to March 2021 and underwent dose evaluation by therapeutic drug monitoring (TDM). In addition, the relationships among birth weight, gestational age, AMK peak and trough values, total duration of AMK administration, and total AMK dose were examined separately for nephrotoxicity and ototoxicity. AMK was administered OD in 38 patients and every-48-h in 62 patients. Nephrotoxicity was observed in 8 patients on OD versus 36 patients on every-48-h administration (P < .001), and ototoxicity was observed in 2 patients on OD versus 12 patients on every-48-h administration (P = .192). For nephrotoxicity, only the trough value was relevant (P = .007). In terms of ototoxicity, there were no influencing factors. The risk of nephrotoxicity was higher with every-48-h AMK administration than with OD AMK administration, with nephrotoxicity depending on the trough value. However, compared with OD, the every-48-h group had lower body weight and possibly poorer original renal function. In addition, ototoxicity did not differ by administration method. Based on these results, every-48-h administration of AMK can be used as safely as OD by performing TDM and preventing high concentrations.

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Section: (100%) Nssupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of nephrotoxicity and ototoxicity following amikacin administration once daily or every 48 hours in neonates

et al. 2022

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Ototoxic Drug Exposure and Hearing Loss in Neonates: A Scoping Review

Rameshsankar,

Seethapathy,

Balakrishnan

2024

Am J Audiol

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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. Supplemental Material: https://doi.org/10.23641/asha.26814700

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Knowledge of final year medicine, pharmacy, audiology and nursing students in South Africa on drug-induced ototoxicity: A pilot study

Mogole

Schellack

Hollander

et al. 2019

SAJCD

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BackgroundThere is a high prevalence of human immunodeficiency virus (HIV), tuberculosis (TB), cancer and malaria in South Africa, and the drugs used to treat these conditions can be ototoxic. It is therefore important that healthcare professionals are able to identify and understand these drugs and their effects to ensure effective care of the patient.ObjectiveThis study aimed to assess the knowledge regarding pharmacotherapy-induced ototoxicity amongst final year, medicine, pharmacy, audiology and nursing students across South African universities.MethodsA descriptive cross-sectional study design was used, and data were collected via a self-administered online questionnaire. Non-probability purposive sampling was used to identify the participants at the universities which train audiologists, pharmacists, medical and nursing students.ResultsAn overall response rate of 41% (n = 720) was obtained. Sixty-four per cent (n = 461) of respondents were women (median age: 23 years). The majority of the respondents (95%) knew what pharmacotherapy-induced ototoxicity was, but a few (39%) knew the general signs and symptoms of ototoxicity. Furthermore, just less than half of the sample (48%) could identify the specific ototoxic medicines and the type of damage caused by this medication.ConclusionTo manage pharmacotherapy-induced ototoxicity effectively, a multidisciplinary healthcare team must have sufficient knowledge about ototoxicity. Therefore, efforts should be made to introduce extensively concepts of pharmacotherapy-induced ototoxicity into the undergraduate curricula of pharmacy, medical, nursing and audiology programmes.

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A pilot study on the use of amikacin in neonates: Who should be monitored for ototoxicity?

Cited by 3 publications

References 10 publications

Evaluation of nephrotoxicity and ototoxicity following amikacin administration once daily or every 48 hours in neonates

Evaluation of nephrotoxicity and ototoxicity following amikacin administration once daily or every 48 hours in neonates

Ototoxic Drug Exposure and Hearing Loss in Neonates: A Scoping Review

Knowledge of final year medicine, pharmacy, audiology and nursing students in South Africa on drug-induced ototoxicity: A pilot study

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