1264 Is High Vancomycin Levels in Neonates Associated with Hearing Loss? a Case Series

Abstract

Objectives: To see if there is any evidence of association between high vancomycin levels and hearing loss in neonates.

Methods: This is a case series of 6 neonates who had documented high peak levels of Vancomycin of more than 40 mg/l with further follow up made regarding hearing loss. A total of 214 neonates received Vancomycin in a tertiary Neonatal unit between Jan 2001 and Dec 2004. Vancomycin was either administered intravenously as daily divided regime or continuous infusion.

Of the 6 Neonates, 3 were born at less than 28 week gestation, 2 were between 32-34 weeks gestation and 1 was a term neonate. Among 6 neonates 1 had high vancomycin levels due to drug error (10 times the prescribed dose) and 2 neonates had preexisting congenital renal problems accounting for the high levels. Vancomycin levels was more than 100 mg/l in 2 neonates. No intervention apart from reducing or spacing out the doses were made.

Results: There was no demonstrable hearing loss on Auditory Brainstem Response (ABR) for 2 infants done at 1 year of age. Other 4 neonates were followed up and there were no concerns reported by the parents regarding childs hearing.

Conclusion: This small case series suggests that Vancomycin does not appear to be ototoxic even in high levels and adds to the increasing evidence that Vancomycin is not associated with ototoxicity in neonates. Further research needs to be done for association of Vancomycin with hearing loss.

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