Comment
Author: Admin | 2025-04-28
In the feces. Neomycin is quickly and almost totally absorbed from body surfaces (except the urinary bladder) after local irrigation and when applied topically in association with surgical procedures. With repeated dosing, progressive accumulation occurs in the inner ear. Release occurs slowly over several weeks after dosing has been stopped. Hearing ototoxicity from oral absorption of Neomycin has been reported (Rappaport et al, 1986) and there may also be toxicity from ear drops in patients with perforated ear drums. This issue is still unsettled (as of 12/1/98). Neomycin toxicity is often delayed in onset and may not be noted until long after neomycin has been discontinued (Information primarily from the manufacturers literature, Teva Pharmaceuticals, 11/1999). Kanamycin, also an aminoglycoside, was developed in 1957, and has been replaced by newer aminoglycosides such as gentamicin, tobramycin, netilmicin, and amikacin. It is not thought to be as ototoxic as neomycin. Streptomycin, the first clinically used aminoglycoside is now used primarily in treating tuberculosis because many gram-negative bacteria are resistant and because of substantial ototoxicity. Streptomycin is now rarely used in the United States. Tobramycin is discussed here. Vancomycin is discussed here; Vancomycin is not an aminoglycoside. Minocycline in large doses is associated with dizziness, sometimes attributed to vestibular side effects. One would not think that this drug would cause vestibular damage however as it is not an aminoglycoside.References concerning specific antibiotics:Antibiotics for which there is some suspicion of ototoxicity Antibiotic with suspected ototoxicity Comment Floxins (i.e. fluoroquinolones) Anecdotal evidence of dizziness Comment: Although there is some evidence for dizziness, it is unlikely that the floxins are ototoxic. Occasionally a persistent ataxia (unsteadiness) is reported following use of a floxin (e.g. ciprofloxacin, etc). All cases so far are anecdotal and there is no strong evidence for ototoxicity. Toxicity, if it exists, might involve some other structure than the ear, such as the cerebellum or perhaps the vestibular nerve (see below). Because toxicity is so sporadic it may require both exposure as well as a genetic predisposition for toxicity. Also, some of the floxins can have an effect on blood glucose. Gatifloxicin (Tequin) can cause
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