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Original Article

Ototoxicity: A Clinical Review

Pages 325-336 | Published online: 07 Jul 2009
 

Abstract

Many drugs have been known at one time or another to produce sensorineural hearing loss. They include such commonly-used agents as salicylates and diuretics, but the most important of them are the ototoxic antibiotics, particularly those of the aminoglycoside group. All members of this 'useful but unruly family of basic streptomyces antibiotics' (Hawkins) are closely related to one another in their microbiology, pharmacology and toxicity.

The risk is increased by poor renal or hepatic function, and with all of them, there may be a latent period between the termination of administration and the patient's awareness of a hearing loss. This delay in the onset of a hearing loss may make the prescribing doctor entirely unaware of the symptoms he has produced, as also may the prescription of various compound preparations by a physician who is ignorant of their contents or side effects.

Contrary to a widely held belief that the aminoglycoside antibiotics are harmful only when they are injected, they may also damage the hearing when they are administered orally or topically.

Résumé

On sait que plusieurs produits peuvent causer une surdité de perception. Parmi eux se trouvent les salicylates, certains diurétiques, et d'autres produits employés couramment, en particulier des antibiotiques, dont les plus toxiques sont les aminoglycosides, Hawkins avait applelé ce groupe d'antibiotiques produits par les streptomyces Inutile, mais difficilement controClable. Ils se rapprochent tous par leur microbiologie, leur pharmacologie et leur toxicité.

Une fonction rénale ou hépatique réduite augmente les risques de surdité et il peut y avoir une période latente entre la fin du régime thérapeutique et une diminution de l'ouïe chez le malade. Ce délai empèche le médecin traitant de se render compte des symptômes qu'il a produit, comme d'ailleurs du contenu exact des préparations utilisées.

Les antibiotiques aminoglycosides peuvent endommager l'ouïe s'ils sont administrés par voie orale ou superficielle et non seulement par voie intraveineuse ou intramusculaire.

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