Audiometry and intravenous aminoglycosides

Irreversible vestibular and auditory damage can occur with intravenous aminoglycoside use, even when serum levels are in range, and certain heritable mitochondrial mutations increase this risk.

Upon initiation of an intravenous aminoglycoside, where possible, ask patient or patient's parent/carer:

• Is there any family history of deafness or deafness after receiving antibiotics?

During aminoglycoside therapy evaluate the patient for evidence of aminoglycoside ototoxicity and/or vestibular toxicity daily for an in-patient, during clinic appointment or OPAT review by asking:

• Have you developed any new hearing problems, ringing in the ears, or a feeling of fullness/popping in the ears?
• Have you developed any new blurred vision, or vision that seems to ‘jump’ during head movement?
• Have you experienced any dizziness or a sense that the room is spinning around you (vertigo)?
• Have you noticed any new problems with balance or feeling unsteady on your feet?

If suspect ototoxicity and/or vestibular toxicity, review the need for aminoglycoside treatment versus alternative options. For patient with suspected ototoxicity refer to audiology.

See below for referral information and additional audiometry assessment criteria.