A study of effect of aminoglycoside therapy on auditory brainstem evoked responses in preterm and term neonates

Authors

  • Mukesh Kumar Department of Pediatrics, Shriram Hospital, Jodhpur, Rajasthan, India
  • Manish Parakh Department of Pediatrics, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • D. R. Dabi Department of Pediatrics, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • B. D. Gupta Department of Pediatrics, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20203168

Keywords:

Aminoglycosides, Auditory brainstem evoked responses, Hearing screening, Neonates, Ototoxicity

Abstract

Background: Aminoglycosides are widely used drugs in neonates with associated ototoxic side effects, that can be diagnosed with auditory brainstem evoked responses, which is the recommended screening technique in neonatal intensive care unit infants.  This study was conducted to evaluate the effect of aminoglycoside therapy on auditory brainstem evoked responses in term and preterm neonates.

Methods: A cross-sectional case control study. Two groups of 26 term and 22 preterm neonates who received aminoglycosides, with no other known risk factors for ototoxicity, were compared with suitable matched control group of 10 neonates in each. ABER was done after at least 5 days of aminoglycoside therapy and results were compared to suitable matched controls.

Results: Mean latency of wave I in term neonates at 90 dB and 60 dB and mean interwave latencies of I-V waves in preterm neonates at 30 dB was higher in study group and statistically significant. No statistically significant difference in any of ABER parameters was observed in any group, at all other intensities.

Conclusions: Wave I latency was prolonged in study group of term neonates at two intensities which indicates effect of aminoglycoside therapy on distal portion of acoustic nerve. But as there were no such findings at other intensities in term study group and in preterm study group and moreover no other ABER abnormalities were observed, it was concluded that the aminoglycoside therapy has low potential for ototoxicity. Authors support the ABER screening for early detection of hearing abnormalities, and recommend study on larger group of neonates and meta-analysis for final conclusion for evidence-based recommendations to use aminoglycosides in neonates, in view of audiometric and neurological abnormalities.

References

John M, Balraj A, Kurien M. Neonatal screening for hearing loss: pilot study from a tertiary care centre. Indian J Otolaryngol Head Neck Surg. 2009;61(1):23-6.

Al-Kandari JM, Alshuaib WB. Newborn hearing screening in Kuwait. Electromyogr Clin Neurophysiol. 2007;47(6):305-13.

From national consultation meeting for developing IAP guidelines on neurodevelopmental disorders under the aegis of IAP childhood disability group and the committee on child development and neurodevelopmental disorders, Paul A, Prasad C, Kamath SS, Dalwai S, Nair MK, Pagarkar W. Consensus statement of the Indian academy of pediatrics on newborn hearing screening. Indian Pediatr. 2017;54(8):647-51.

Nagapoornima P, Ramesh A, Srilakshmi, Rao S, Patricia PL, Gore M, et al. Universal hearing screening. Indian J Pediatr. 2007;74:515-49.

Bitner-Glindzicz M, Rahman S. Ototoxicity caused by aminoglycosides. BMJ. 2007;335(7624):784-5.

Gao Z, Chen Y, Guan MX. Mitochondrial DNA mutations associated with amino glycoside induced ototoxicity. J Otol. 2017;12(1):1-8.

Foster J, Tekin M. Aminoglycoside induced ototoxicity associated with mitochondrial DNA mutations. The Egypt J Med Human Genet. 2016;17:287-93.

Joint Committee on Infant Hearing. Year 2007 position statement: Principles and guidelines for early detection and intervention programs. Pediatrics. 2007;120(4):898-921.

Jewett DL, Williston JS. Auditory evoked far field s averaged from the scalp of humans. Brain. 1971;94:681-96.

Celsia GG, Brigell MG. Auditory evoked potentials. In: Niedermeyer E, Lopes Da Silva F, editors. Electroencephalography: basic principles, clinical applications, and related fields 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2005:1045-1061.

Agarwal V, Shukla R, Misra P, Kapoor RK, Malik GK. Brainstem auditory evoked responses in newborn with hyperbilrubinemia. Indian Pediatr. 1998;35:513-8.

Bernard PA, Pechere JC, Hebert R. Altered objective audiometry in aminoglycosides-treated human neonates. Arch Otorhinolaryngol. 1980;228:205-10.

Kohelet D, Usher M, Arbel E, Arlazoroff A, Goldberg M. Effect of gentamicin on the auditory brainstem evoked response in term infants: A preliminary report. Pediatr Res. 1990;28:232-4.

Tsai CH, Tsai FJ. Auditory brainstem responses in term neonates treated with gentamicin. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1992;33(6):417-22.

Ito H. Auditory brainstem response in NICU infants. Int J Pediatr Otorhinolaryngol. 1984;8(2):155-62.

Finitzo-Hieber T, McCracken GH, Roeser RJ, Allen DA, Chrane DF, Morrow J. Ototoxicity in neonates treated with gentamicin and kanamycin: results of a four-year controlled follow-up study. Pediatr. 1979;63(3):443-50.

Finitzo-Hieber T, McCracken GH, Brown KC. Prospective controlled evaluation of auditory function in neonates given netilmicin or amikacin. J Pediatr. 1985;106(1):129-36.

McCracken GH. Aminoglycoside toxicity in infants and children. Am J Med. 1986;80(6B):172-8.

Adelman C, Linder N, Levi H. Auditory nerve and brain stem evoked response thresholds in infants treated with gentamicin as neonates. Ann Otol Rhino Laryngol. 1989;98:283-6.

Kilic I, Karahan H, Kurt T, Ergin H, Sahiner T. Brainstem evoked response audiometry and risk factors in premature infants. Marmara Med J. 2007;20(1):21-8.

Naanvati RN, Hakeem MA, Nithya G, Swar BD. Serum amikacin levels and hearing in very low birth weight (VLBW) infants. J Clin Diagnos Res. 2010;4(6):3323-6.

Chayasirisobhon S, Yu L, Griggs L, Westermoreland SJ, Leu N. Recording of brainstem evoked potentials and their association with gentamicin in neonates. Pediatr Neurol. 1996;14(4):277-280.

Hess M, Finckh-Krumer U, Bartsch M, Kewitz G, Versmold H, Gross M. Hearing screening in at-risk neonate cohort. Int J Pediatrics Otorhinolaryngol. 1998;46:81-9.

Zamani A, Daneshjou K, Takand J. Estimating the incidence of neonatal hearing loss in high risk neonates. Acta Medica Iranica. 2004;42(3):176-80.

Maqbool M, Najar BA, Gattoo I, Chowdhary J. Screening for hearing impairment in high risk neonates: a hospital-based study. J Cain Diagn Res. 2015;9(6):18-21.

Usami S, Abe S, Shinkawa H, Kimberling WJ. Sensorineural hearing loss caused by mitochondrial DNA mutations: special reference to the A1555G mutation. J Commun Disord. 1998;31:423-34.

Cox LC, Hack M, Metz DA. ABR abnormalities in the very low birthweight infants: Incidence and risk factors. Ear Hear. 1984;5:47-51.

Rao SC, Srinivasjois R, Hagan R, Ahmed M. One dose per day compared to multiple doses per day of gentamicin for treatment of suspected or proven sepsis in neonates. Cochrane Database Syst Rev. 2011;(11):CD005091.

Contopoulos-loannidis DG, Giotis ND, Baliatsa DV, Loannidis JP. Extended-interval aminoglycoside administration for children: a meta-analysis. Paediatr. 2004;114(1):111-8.

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Published

2020-07-22

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Original Research Articles