What are the possible adverse effects of prolonged use of aminoglycoside in treatment of urinary tract infection (UTI) in males?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

As previously stated, prolonged use of aminoglycosides (>2wk) is a complication risk factor, including for cranial nerve (CN) VIII damage (hearing loss and vestibular dysfunction). Fortunately, most aminoglycoside use in treating serious UTIs is limited to less than 1 week.

Unfortunately, monitoring for CN VIII dysfunction is less than optimal; by the time it is detectable (even subclinically, by weekly audiograms and/or electronystagmograms), the damage has been done and is irreversible. This is because of differences in half-lives between sera and because of the endolymph and perilymph that bathe the inner ear. However, monitoring allows the damage to be minimized. Remember that the auditory and vestibular systems function independently; therefore, consideration should be given to monitoring each.

Animal models suggest that doses of aminoglycosides given at night or to a patient who has been fasting or is dehydrated may be more ototoxic. The possibly protective roles of calcium and calcium channel blockers await further study.


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