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Bitner-Glindzicz and Rahman highlight an important side effect associated with aminoglycoside administration and a possible screening method to reduce this potential risk.1 They do not, however, point out the lack of clinical practicality of the genetic test.
In a recent case of acute mastoiditis complicated by a lateral sinus thrombosis it was decided to start administering intravenous gentamicin after mastoidectomy. It was suggested that this genetic screening test be performed before administration. On contacting the genetics department, we were informed that the test could not be performed at our own hospital and would be referred elsewhere for analysis. We were also informed that a result would take two to three days. Gentamicin was therefore started before obtaining the result of the genetic test on the basis of the clinical severity of the case.
Although this form of screening could reduce the rates of ototoxicity secondary to aminoglycoside administration, its widespread use is limited by its practicality. Aminoglycoside treatment is started most commonly in the acute setting, where withholding treatment for two or three days for the results of a genetic screening test would not be in the best interests of the patient.
Competing interests: None declared.