Audiologic threshold monitoring of patients receiving ototoxic drugs: Preliminary report

An effort was made to determine the efficacy of auditory threshold monitoring of patients receiving ototoxic drugs. Forty-four patients treated with either tobramycin or vancomycin for osteomyelitis were tested at the beginning of treatment, following treatment, and twice weekly during treatment when possible. All patients had renal function carefully monitored. Peak and trough drug levels were kept out of the toxic range throughout the study. In no patient did indisputable ototoxicity occur, and therefore, no conclusion about the most efficacious schedule for auditory monitoring of patients receiving ototoxic drugs was made, and what constitutes a significant intratherapeutic threshold shift is still in question. Until further data are collected, monitoring of renal function and peak and trough drug levels, as well as patient counseling, is recommended. Pretherapy and posttherapy auditory monitoring and intratherapeutic monitoring of high-risk patients and those who develop aural symptoms may prove beneficial.