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PO-0463 Low Incidence Of Neurosensorial Deafness In Infants Treated With Hypothermia For Neonatal Hypoxic-ischaemic Encephalopathy Can Be Related To Avoidance Of Ototoxic Antibiotics
  1. R Gouveia,
  2. A Prior,
  3. I Sampaio,
  4. C Moniz,
  5. AM Graca
  1. NICU – Department of Pediatrics, Lisbon Academic Medical Center, Lisboa, Portugal

Abstract

Background and aims Hypoxic-ischaemic encephalopathy is a risk factor for neurosensorial deafness. Incidences up to 10% were described by some groups. Hypothermia can alter drug metabolism leading to increased risk of toxic levels. We aim to evaluate the incidence and identify risk factors for deafness in our patients.

Methods We studied all infants treated with hypothermia at our NICU in a 4-year period (2010–2013). Demographic and clinical data, including drug use and hearing screening result, were collected from our prospectively collected database. Hearing follow-up of children now over 24 months was also collected.

Results 50/59 newborns treated survived (66% male, mean GA 39 weeks, mean BW 3121 g, median Apgar scores 2/4/5, 84% ventilated >4 days, 54% inotropes, 6% >2 anticonvulsants, 64% furosemide). Initial antibiotherapy was ampicilin+cefotaxime in 96%, vancomycin was used in 12% for late sepsis (toxic levels in 1/6 patients). Auditory evoked-potentials performed in 92%, acoustic otoemissions performed in 4%, no hearing screening test on 4%. Only 2 failed on hearing screening, one died and the other is being evaluated. On follow-up of 17 patients at 2 years, 16 have normal hearing and 1 is being treated for hearing loss due to glue ear.

Conclusions Despite potential risk factors on our patients, the occurrence of deafness was rare. Our protocol that avoids the use of gentamicin as first line antibiotic therapy can explain the important difference in incidence when compared to other studies. When their use is unavoidable, close monitoring of ototoxic drug levels should be performed.

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