Ototoxicity: etiology and issues.

Several classes of drugs have been identified as having ototoxic potential: aminoglycoside antibiotics, other basic antibiotics, antimalarial drugs, loop diuretics, and salicylates. Various chemicals have also been implicated in causing ototoxicity. If certain predisposing conditions are present when a potentially ototoxic drug is administered, the risk of ototoxicity is increased. These conditions include impaired renal functioning, pregnancy, previous or concomitant treatment with another potentially ototoxic drug, inherited susceptibility to ototoxicity, and the effects of noise. Other conditions that have been associated with ototoxicity for which there is a lack of strong scientific support are age, sex, and pre-existing hearing loss. The physician's awareness of predisposing conditions combined with rational drug usage can reduce ototoxic risk to the individual.