Gentamicin Toxicity

Gentamicin is a strong aminoglycoside antibiotic that is used to prevent or treat a wide variety of bacterial infections. It is effective against a wide range of gram negative and gram positive organisms and it is of particular value in the treatment of serious life-threatening infections.

Gentamicin is very useful in the treatment of infections. However, if gentamicin is administered incorrectly, for example if the dose is too high or if the therapy is provided for too long, it can cause ‘gentamicin toxicity’ or ‘gentamicin poisoning’ which can cause significant harm to the patient. The main side effects are nephrotoxicity and ototoxicity.

Nephrotoxicity is where gentamicin damages the kidneys, reducing their ability to excrete urine and waste products. Gentamicin is excreted via the kidneys so if the patient has or develops impaired renal function, there is a greater risk of nephrotoxicity particularly in patients who receive a high dose or prolonged therapy.

Ototoxicity is where gentamicin damages the inner ear, causing difficulties with hearing and balance. Pre-existing damage to the auditory nerve increases the susceptibility of the patient to ototoxicity.

Patients who experience gentamicin toxicity usually develop symptoms of slurred speech, stumbling, falling, and incoordination, blurred vision, hearing problems and oscillopsia. The physical and psychological impact can be devastating and patients may be unable to work, require extensive adaptions to their home or various aids and equipment or even need care and assistance.

It is important that the patient is provided with all material information about the risks and benefits of the treatment, including details of any reasonable alternative options, before gentamicin therapy is commenced. Failure to provide this information may mean that the patient has not provided informed consent to the treatment. If the patient can establish that they would not have consented to gentamicin therapy if they had been properly advised, they may be able to bring a claim for compensation for any harm that they have suffered as a result of the treatment.

Before gentamicin therapy commences, doctors should check that the patient does not have a pre-existing condition that would contraindicate its use. Gentamicin should not be administered to patients with kidney disease, hearing problems or those with conditions causing muscle weakness.

The appropriate dosage should be calculated according to the patient’s age, weight and height. Hearing and kidney function should be measured and monitored throughout the treatment. ‘Peak’ and ‘trough’ blood levels should be checked throughout the gentamicin therapy. If there are any concerns then the dosage should be changed or the time interval between doses should be increased.

In order to reduce the risk of adverse reactions, the National Institute for Health and Care Excellence recommends that parenteral gentamicin therapy should not exceed 7 days.

It is important to highlight that there are situations where gentamicin was the appropriate treatment, it was administered at the correct dose and for the correct length of time, but it has caused adverse effects.

The specialist medical negligence solicitors at Curtis Solicitors have experience of advising clients who have suffered avoidable gentamicin toxicity in the following circumstances:

  1. Failing to inform the patient of the material risks and side effects of gentamicin
  2. Prescribing gentamicin to a patient with impaired renal function
  3. Repeated administration of gentamicin to a patient with pre-existing balance issues
  4. Failing to calculate a suitable dosage
  5. Failing to appropriately monitor gentamicin levels in the blood
  6. Failing to adjust the dose and/or timing of doses in response to blood test results
  7. Failing to check for, recognise or respond to the symptoms of early gentamicin toxicity

We will secure your medical records and carefully analyse them in order to consider the following factors which may indicate negligence in the treatment that was provided to you:

  1. Was gentamicin a reasonable treatment for your condition or were alternatives available?
  2. Were you provided with all material information to enable you to provide informed consent to the administration of gentamicin?
  3. Were appropriate checks carried out before gentamicin was administered? This may include considering any other medication that you were taking, your weight and your renal function.
  4. Was the dose calculated correctly?
  5. Was the dose administered correctly?
  6. Were blood tests performed during the therapy and were the results appropriately acted upon?
  7. What adverse effects have you suffered and when did they develop?
  8. Do these adverse effects have a continued impact on you?

If you believe that you have suffered gentamicin toxicity because of negligence care, you should seek advice from a specialist medical negligence solicitor in order to make a claim for compensation for the avoidable harm that you have suffered.

If you wish to discuss a potential clinical negligence claim with our specialist solicitors you can email us, use our online enquiry form, or call us for free on 0800 008 7450.