Aminoglycosides
Aminoglycosides are a class of powerful antibiotics used to fight infections like Pseudomonas, E. Coli, and Klebseilla. These medications can also be combined with other antibiotics to help fight these bacteria. The aminoglycosides include gentamycin, amikacin, tobramycin and streptomycin. Gentamycin is one of the more commonly used antibiotics.
There are several unfortunate side effects of the aminoglycosides including kidney, nephrotoxicity, and ear, ototoxicity, damage. These side effects can occur after one dose of the medication or after treatment. The consequences of the medication side effects can result in lifelong communication, educational and social issues for the patient. The risk of hearing or kidney damage increases when a higher dose of the drug or long duration of treatment is needed.
The aminoglycosides are provided through an IV and the patient is generally hospitalized during treatment. Blood levels are monitored to prevent the hearing and kidney damage.
Ototoxicity
The hearing damage that occurs is hearing loss starting with the higher frequencies and is usually bilateral (both ears). The damage can also lead to tinnitus, or ringing, or damage to the vestibular system. The vestibular system controls our sense of balance. With the ototoxicity caused by aminoglycosides, one can have a sense of disequilibrium or unsteadiness.
Nephrotoxicity
The kidney damage resulting from aminoglycoside use can result in decreased kidney function or reduction in the production of urine. The kidney damage is acute tubular necrosis where the filtering mechanism of the kidney is no longer functional. Without adequate urine production, various toxins will build up in the body and cause further damage to the liver and heart. If you have existing poor kidney function, with aminoglycoside damage you may be at risk for needing hemodialysis. The kidney damage does not usually occur until a greater duration of antibiotic use, 5-7 days, occurs. In general, if one does not have pre-existing decreased kidney function, the damage will reverse with time.
Chloramphenicol
Chloramphenicol is a powerful antibiotic used to treat a wide range of infections when other antibiotics cannot be used. Chloramphenicol is rarely used in the United States any longer. The toxicity of chloramphenicol can result in bone marrow suppression and irreversible aplastic anemia. The bone marrow suppression will result in decreased levels