Relation between Serum Iron Level and Amikacin Ototoxicity

Abstract

Objective: Aminoglycosides are highly effective against bacteria but have serious side effects including ototoxicity and nephrotoxicity. Iron-aminoglycoside complex causes ototoxicity by creating free radicals. We study the relation between serum iron level and amikacin ototoxicity to learn whether more iron results in more ototoxcity.

Method: We examined burned patients with amikacin prescription. Patients were divided into Group 1 (89 patients with serum ferritin above 150 ng/mL) and Group 2 (92 patients with serum ferritin below 150 ng/mL). Their hearing thresholds and red blood cell indices were compared using t and paired t test.

Results: In comparing the 2 groups, thresholds of Group 1 were more than Group 2 at all frequencies, and the difference was statistically significant with P < .001. Maximum threshold shift in Group 1 was greater than 20 dB and in Group 2 was less than 10 dB, at 8000Hz. Again, this result was statistically and clinically significant with a P < .001. Finally, mean corpuscular volume was greater in Group 1 than Group 2, and the P-value for the test was around .001.

Conclusion: Our results suggest that iron level is related to aminoglycoside ototoxicity. More iron can create more ototoxicity, and iron deficiency may inhibit aminoglycoside ototoxicity. An increase in MCV may be due to higher serum ferritin and an indication of more ototoxicity.