Hearing of School Age Children Who Received High Dose Gentamicin as Neonates :

We are all familiar with the potential ototoxic effects of receiving gentamicin in infancy, which is why we are careful to monitor peak and trough levels with the hope of not damaging the hearing of these infants. How common is a hearing disability attributed to gentamicin use in infancy? To answer that question, Hemmingsen et al (10.1542/peds.2019-2373) followed a cohort of neonates who received high-dose gentamicin between 2004 to 2012 through school age and compared their audiometry findings with those of a healthy age-matched control group. The authors tested 219 gentamicin-exposed and 33 healthy control children and looked at factors such as birth weight, highest trough plasma concentration of the drug, and median cumulative dose. The study found no differences in hearing thresholds noted at school age between the gentamicin-exposed and the healthy controls after controlling for confounders like birth weight and postnatal middle ear disease.  While the numbers are small, the findings are optimistic. These findings should be reaffirmed in other studies but do provide a better understanding of the current risk of ototoxicity.