Nephrotoxicity and ototoxicity following irrigation of wounds with neomycin.

Renal failure and ototoxicity developed in two patients following wound irrigation with neomycin. In both patients the renal failure was reversible, but the deafness was progressive despite withdrawal of the neomycin. In one patient the serum neomycin concentration was still markedly elevated (42 microgram/ml) 2 days after use of the drug was discontinued. The authors suggest that irrigation of large open wounds with neomycin is dangerous since toxic blood concentrations may ensue. The benefits conferred by neomycin irrigation should be weighed against the possible danger of permanently impaired hearing.