Publication

Abstract : Objectives This study aimed to assess the prevalence of Amikacin induced ototoxicity in neonates in a tertiary care hospital and to elucidate the possible risk factors. Design: A retroprospective study on two hundred and sixty neonates admitted to the neonatal intensive care unit (NICU), who were treated with Amikacin. Ototoxicity was assessed by measuring the hearing impairment in neonates using Brainstem Evoked Response Audiometry (BERA) at the time of discharge. A repeat BERA was done for those who failed during the initial BERA. Results The prevalence of Amikacin induced ototoxicity in neonates was found to be 11.2% (29 out of 260). Among these 29, only 16 had a follow up BERA and 8 of them showed persistent hearing impairment at the 3 months BERA. Genetic anomalies had showed a significant association with hearing impairment (P value = 0.001). Among the 16 who were diagnosed with a genetic condition 43.8% of them had hearing impairment.. The value of CRP (mg/dl) during the 1st course of Amikacin therapy had shown a border line significance (P value =0.067) with hearing impairment. Conclusion: Genetic abnormalities have shown a significant relationship with hearing impairment, hence the use of Amikacin in such neonates should be monitored. We attribute the low prevalence rate of ototoxicity in the NICU population, even in the absence of a therapeutic drug monitoring system for Amikacin to the dosage regimen being used and to the good clinical practices being followed in the NICU.