KANAMYCIN .2. OTOTOXICITY

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Abstract
Hearing loss was the most frequent manifestation of ototoxicity in patients on long-term kanamycin therapy. It was detected after total doses ranging from 32 to 134 g in 17 of 21 patients who received 0.5 to 1.5 g daily, and after 37 to 54 g in 2 of 12 patients who received 3 g weekly. The incidence of ototoxicity was closely related to the total amount of the kanamycin administered. Hearing loss occurred first in the higher frequencies in all cases. Withdrawal of kanamycin resulted in cessation of progression of the hearing loss in all but one patient, who had impaired renal function. He became totally deaf. Two patients showed partial recovery of hearing during the weeks following withdrawal of the drug. In all of the other patients, the hearing remained at the level at which it was when kanamycin was stopped. Tinnitus was present in 13 of the 19 patients who showed a hearing loss, and preceded or coincided with the appearance of the loss in all but one case. It diminished in 4 patients following cessation of kanamycin treatment. Tinnitus was absent in patients who did not show a hearing loss. One patient developed ataxia. He recovered during the following 4 months. The incidence of hearing loss in patients on long-term kanamycin treatment was greater than that reported in patients who had received similar dosage of streptomycin and dihydrostreptomycin. Attention is called to the greatly increased probability of serious hearing impairment when kanamycin is given to patients with renal insufficiency. Kanamycin closely resembles neomycin in ototoxicity and nephrotoxicity, just as it does in chemical structure and antimicrobial activity.

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