| Description |
The results of this study indicate that in the newborn population, an association exists between: 1) the administration of gentamicin and/or furosemide, and 2) the presence of low birth weight infants, and the dependent variable, hearing loss. More than 20 variables could potentially effect hearing in this patient population, so the likelihood of a strong correlation existing between any single variable and hearing loss is small. However, a statistically significant correlation between hearing loss and four variables did exist. These results indicate the need of a follow-up study controlling for many of the variables associated with hearing loss. Some factors that could be controlled for in a future study would be drug dosage, method of administration, and serum drug concentrations. ABR testing should be done early to determine a baseline response, and repeat testing should be done at a fixed interval after drug therapy. Variables such as birth weight and gestational age could be controlled, limiting their effect on hearing loss. In this way a better correlation and stronger association between independent variables and hearing loss could be obtained. In addition, more specific information regarding the ototoxicity of the agents and factors associated with that ototoxicity, such as dose and duration, route of administration, and administration of concurrent ototoxic drugs may be obtained. If gentamicin and furosemide have the potential for ototoxicity, especially in the risk population, it would be important to identify those patients at risk. By identifying those patients at risk, a more precise treatment and dosing schedule and more careful monitoring of therapy with these drugs may reduce the high incidence of hearing loss in this population. The implication is for continued surveillance of those patients at increased risk for hearing loss who are treated with aminoglycosides and/or furosemide. Based on the results of this study, low birth weight infants in the NBICU or newborn nursery area should be monitored closely for hearing loss. Those patients who are receiving gentamicin and/or furosemide should be monitored for toxicity and screened for the presence of hearing loss be ABR audiometry until more specific characterization of the ototoxicity produced by these agents is available. |
