Finding ways to solve or prevent aminoglycoside-induced ototoxicity?

Aminoglycoside (AG), which was first discovered in 1944, is widely used in treating severe Gram-negative bacterial infections (1). Gentamicin, kanamycin, amikacin and neomycin are the major AGs used nowadays, and vancomycin is the drug of choice for methicillin-resistant Staphylococcus aureus (MRSA) infection. Although other antibiotics can also target Gram-negative bacteria such as penicillins and cephalosporins, AGs remain to be the popular choice because of their economical and clinical advantages including low cost, rapid bactericidal activity and low incidences of resistance (2). However, the adverse effects of reversible nephrotoxicity and irreversible ototoxicity limit their use to short term therapy (3,4). Precaution is needed for treating senior patients who are prone to have hearing, vestibular and renal dysfunctions. Identification of the predisposing factors of such toxicities will allow us to maximize the benefit of using AGs and greatly improve the therapeutic outcome.