Ototoxicity of Oral Neomycin and Vancomycin

Kavanagh, Kevin T.; McCabe, Brian F.

doi:10.1002/lary.1983.93.5.649

Cited by 24 publications

(11 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, even poorly absorbed aminoglycosides are not completely devoid of untoward effects. Indeed, both ototoxicity [24,25,26] and nephrotoxicity [27] have been reported after oral neomycin especially in patients with renal dysfunction. Such patients can in fact accumulate toxic levels of the antimicrobial since the kidneys represent the major route of drug excretion [28].…”

Section: Introductionmentioning

confidence: 99%

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

Scarpignato

Pelosini²

2006

Digestion

101

View full text Add to dashboard Cite

Rifaximin (4-deoxy-4′-methylpyrido[1′,2′-1,2]imidazo [5,4-c]rifamycin SV) is a product of synthesis experiments designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (GI) absorption while retaining good antibacterial activity. Both experimental and clinical pharmacology clearly show that this compound is a non-systemic antibiotic with a broad spectrum of antibacterial action covering Gram-positive and Gram-negative organisms, both aerobes and anaerobes. Being virtually non-absorbed, its bioavailability within the GI tract is rather high with intraluminal and fecal drug concentrations that largely exceed the minimum inhibitory concentration values observed in vitro against a wide range of pathogenic organisms. The GI tract represents therefore the primary therapeutic target and GI infections the main indication. This antibiotic has therefore little value outside the enteric area and this will minimize both antimicrobial resistance and systemic adverse events. Indeed, the drug proved to be safe in all patient populations, including young children. The appreciation of the pathogenic role of gut bacteria in several organic and functional GI diseases has increasingly broadened its clinical use, which is now extended to hepatic encephalopathy, small intestine bacterial overgrowth, inflammatory bowel disease and colonic diverticular disease.

show abstract

Section: Introductionmentioning

confidence: 99%

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

Scarpignato

Pelosini²

2006

Digestion

101

View full text Add to dashboard Cite

show abstract

“…However, even poorly absorbed aminoglycosides are not completely devoid of untoward effects. Indeed, both ototoxicity [27][28][29] and nephrotoxicity [30] have been reported after oral neomycin especially in patients with renal dysfunction. Such patients can in fact accumulate toxic levels of the antimicrobial since the kidneys represent the major route of drug excretion [31].…”

Section: Introductionmentioning

confidence: 99%

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

2005

View full text Add to dashboard Cite

Rifaximin (4-deoxy-4′-methylpyrido[1′,2′-1,2]imidazo- [5,4-c]-rifamycin SV) is a synthetic antibiotic designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (GI) absorption while retaining good antibacterial activity. Both experimental and clinical pharmacology clearly show that this compound is a nonsystemic antibiotic with a broad spectrum of antibacterial action covering Gram-positive and Gram-negative organisms, both aerobes and anaerobes. Being virtually nonabsorbed, its bioavailability within the GI tract is rather high with intraluminal and fecal drug concentrations that largely exceed the minimal inhibitory concentration values observed in vitro against a wide range of pathogenic organisms. The GI tract represents, therefore, the primary therapeutic target and GI infections the main indication. The appreciation of the pathogenic role of gut bacteria in several organic and functional GI diseases has increasingly broadened its clinical use, which is now extended to hepatic encephalopathy, small intestine bacterial overgrowth, inflammatory bowel disease and colonic diverticular disease. Potential indications include the irritable bowel syndrome and chronic constipation, Clostridium difficile infection and bowel preparation before colorectal surgery. Because of its antibacterial activity against the microorganism and the lack of strains with primary resistance, some preliminary studies have explored the rifaximin potential for Helicobacter pylori eradication. Oral administration of this drug, by getting rid of enteric bacteria, could also be employed to achieve selective bowel decontamination in acute pancreatitis, liver cirrhosis (thus preventing spontaneous bacterial peritonitis) and nonsteroidal anti-inflammatory drug (NSAID) use (lessening in that way NSAID enteropathy). This antibiotic has, therefore, little value outside the enteric area and this will minimize both antimicrobial resistance and systemic adverse events. Indeed, the drug proved to be safe in all patient populations, including young children. Although rifaximin has stood the test of time, it still attracts the attention of both basic scientists and clinicians. As a matter of fact, with the advancement of the knowledge on microbial-gut interactions in health and disease novel indications and new drug regimens are being explored. Besides widening the clinical use, the research on rifaximin is also focused on the synthesis of new derivatives and on the development of original formulations designed to expand the spectrum of its clinical use.

show abstract

“…Especially in the earlier literature of internal medicine [2] hearing impairment has been re ported in several cases during local and systemic treat ment with V. Unfortunately, complete audiometric doc umentation is only rarely available. Further reservation concerning the reliability of these reports may be war ranted due to the multimorbidity in these intensive-care patients and the interaction with other ototoxic drugs like aminoglycosides and loop diuretics [3,4], Interestingly, the active principle must be isolated from soil samples of the interior of Borneo, containing the actinomycète Slreptomyces orientalis. After im proved purification methods were developed in the last three decades, the ototoxic and nephrotoxic risks might have decreased.…”

Section: Introductionmentioning

confidence: 99%

Ototoxicity of Vancomycin: An Experimental Study in Guinea Pigs

Lutz

Lenarz

Weidauer

et al. 1991

ORL

View full text Add to dashboard Cite

Vancomycin (V) – a polypeptide antibiotic – is the drug of choice in severe infections with multiresistant staphylococcus spp. Due to the multimorbidity of the patients receiving V, the interactions with known ototoxic agents and the lack of an audiometric documentation, earlier clinical reports of V-associated hearing loss must be carefully interpreted. To elucidate this topic, a controlled animal study considering nonspecific effects was performed. 40 albino guinea pigs with positive Preyer’s reflex and normal hearing were used. The hearing function was controlled by means of brainstem auditory evoked potentials before and after intraperitoneal administration of V (75, 150, 300 mg/kg b.w. for 11–17 days), gentamicin (60 mg/kg b.w. for 26 days), neomycin (100 mg/kg b.w. for 17 days) and sodium chloride solution. The cochleas were dissected for hair cell counting by the surface preparation technique. Additionally, the serum concentrations of V were measured. As a result there was no significant difference in hearing loss between the controls and the animals treated with 75 and 150 mg V; toxic doses of 300 mg V led to a certain threshold elevation after click stimuli, but not after trapezoid stimuli of 1, 4 and 8 kHz. On the other hand, the aminoglycosides as a positive control caused an obvious hearing loss after click and trapezoid stimuli, which was correlated to the amount of outer hair cell loss. Renal damage could be excluded by histological examination of the kidneys and estimation of creatinine in serum. Therefore, treatment with moderate doses of V comparable to clinical conditions does not exhibit a specific ototoxicity as compared to the aminoglycosides. However, serum levels of V should be controlled as a safety measure in older patients and in patients with impaired renal function.

show abstract

Ototoxicity of Oral Neomycin and Vancomycin

Cited by 24 publications

References 42 publications

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

Ototoxicity of Vancomycin: An Experimental Study in Guinea Pigs

Contact Info

Product

Resources

About