The Ototoxic Interaction of Viomycin, Capreomycin and Polymyxin B With Ethacrynic Acid

Abstract

The ototoxic interaction between the aminoglycoside antibiotics (streptomycin, kanamycin, etc.) and the loop-inhibiting diuretics (ethacrynic acid, furosemide and bumetanide) has been well documented. This interaction causes extensive destruction of the hair cells of the cochlea. Brummett et al. (1974) demonstrated that this interaction did not occur with the non-loop-inhibiting diuretics and kanamycin. The present study was undertaken to determine if antibiotics other than the aminoglycosides could produce the ototoxic interaction when combined with a loop-inhibiting diuretic. Three antibiotics-viomycin, capreomycin, and polymyxin B- when given with ethacrynic acid were found to produce cochlear hair cell damage that was similar to that produced by aminoglycoside antibiotics administered with ethacrynic acid. Therefore, the interaction appears to be specific to the loop-inhibiting diuretics but not specific for the aminoglycoside antibiotics.

Large Vancomycin Overdose in Two Premature Infants with Minimal Toxicity

“…Lutz et al 28 found no difference in hearing loss or cochlear hair cell count between guinea pigs receiving a range of vancomycin doses < 300 mg/kg/d for 11 to 17 days and control animals, similar to the findings of others using guinea pig and gerbil models. [28][29][30][31][32] Brummett et al 14,18 have previously summarized the evidence supporting the rarity of vancomycin-associated ototoxicity. Aronoff 33 was unable to detect alteration of renal function in rats at vancomycin doses < 400 mg/kg/d, similar to the observation of others in guinea pigs.…”

Sensorineural Hearing Loss Associated with Intrathecal Vancomycin

“…Although multiple reports of this adverse reaction can be found in the literature, there are no reports of ototoxicity in experimental animals. Davis et al 12 failed to demonstrate ototoxicity of vancomycin in guinea pigs even when the animals were also treated with ethacrynic acid, a drug that augments the ototoxic effects of other ototoxic drugs. Brummett et al 13 guinea pigs and found that vancomycin alone was not ototoxic, but the ototoxic effect was greatly enhanced when vancomycin was administered with gentamicin.…”