Objectives: To determine the incidence of gentamicin vestibulotoxicity with current dosing regimens, and to evaluate the feasibility of routine video-oculography on all patients given gentamicin. Materials and methods: In this prospective incidence study serial horizontal vestibulo-ocular reflex (HVOR) gain measurements were recorded using video-oculography on adult inpatients receiving intravenous gentamicin. The primary outcome was the proportion of patients developing impairment of their HVOR gain. Results: After exclusions, 42 patients were included in the analysis. Three patients (7.1%) developed asymptomatic vestibulotoxicity, exact 95% confidence interval 1.5–19.5%. In two of these patients the deficit resolved within several hours. No patients developed symptomatic vestibulotoxicity. There was no evidence for a generalised reduction in group HVOR gain with time. HVOR gain was not associated with total gentamicin dose, dynamic visual acuity or subjective imbalance. Conclusions and significance: Gentamicin may cause reversible, asymptomatic vestibulotoxicity. Video-oculography may be useful to monitor for vestibulotoxicity in patients treated with gentamcin; however, testing all patients routinely may be challenging.
目的:探讨按目前给药方案用庆大霉素治疗后, 前庭毒性的发生率。评价所有庆大霉素给药患者行常规视频眼科检查的可行性。 材料和方法:在这项前瞻性发病率研究中, 对接受静脉注射庆大霉素的成年住院患者进行了一系列水平前庭-眼反射(HVOR)增益测量。主要结果是HVOR增益受损的患者比例。 结果:经筛选, 42例患者被纳入分析。三名患者(7.1%)发生无症状前庭毒性, 95%置信区间为1.5-19.5%。其中两名患者在几个小时内就痊愈了。没有患者出现症状性前庭毒性。没有证据表明随着时间的推移, 群体HVOR增益普遍减少。HVOR增益与庆大霉素总剂量、动态视力或主观失衡无关。 结论与意义:庆大霉素可引起可逆性的、无症状的前庭毒性。视频眼科检查可能有助于监测使用庆大霉素治疗的患者的前庭毒性;然而, 常规检查所有患者可能会比较困难。