- 期刊
Gentamicin耳毒性－二例報告
Gentamicin-Induced Ototoxicity - Report of Two Cases
摘要
Gentamicin屬於氨基醣苷類抗生素，主要作用於革蘭氏陰性細菌，抑制細菌細胞蛋白質合成，副作用主要為腎毒性及耳毒性。本文提出2例因使用gentamicin造成耳毒性病例，其中1例使用腹膜透析液灌注gentamicin治療腹膜炎造成眩暈及兩耳重聽之症狀，經追蹤1年4個月後，聽力喪失並無改善，且偶有眩暈發作情形。另1例使用gentamicin靜脈滴注1天後產生突發性耳聾及眩暈情形。立即停藥施予其他抗生素治療5天後追蹤純音聽力檢查，聽力明顯恢復，眩暈症狀亦消失。本文中將參考文獻討論gentamicin造成耳毒性之危險因子，另外因其可逆性屬少見現象，故亦就可逆機轉之假說做論述。
並列摘要
Gentamicin, an aminoglycoside antibiotic, has been widely used since 1963 because it is an effective agent against gram-negative bacilli and because it is inexpensive. However, its use is restricted by its nephrotoxicity and ototoxicity. Two cases of gentamicin-induced ototoxicity are reported here. In the first case, a 79 year-old man was treated for peritonitis with gentamicin intraperitoneally via peritoneal dialysate. Vertigo and bilat-eral hearing loss were noted 13 days later. Although the drug was discontinued, the hear-ing loss persisted and vertigo occurred occasionally during the 16 month follow-up period. In the other case, a 53 year-old woman had a sudden onset of deafness and vertigo one day after gentamicin was given to treat a urinary tract infection. Gentamicin was immediately discontinued. There was a significant improvement in hearing and the vertigo subsided 5 days later. This report draws attention to the risk of ototoxicity of gentamicin. It is assumed that early discontinuation of gentamicin may preserve partial function of the outer hair cell. Therefore, recovery of hearing is possible.