Efficacy is diminished and risk of ototoxicity increased in patients with hypoproteinemia (associated with nephrotic syndrome); ototoxicity is associated with rapid injection, severe renal impairment, use of higher than recommended doses, concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs.
www.phac-aspc.gc.ca. The Public Health Agency of Canada (French: Agence de la santÃ© publique du Canada) is an agency of the Government of Canada that is responsible for public health, emergency preparedness, and response and infectious and chronic disease control and prevention.
The Public Health Agency of Canada also contributes a team to the CBRNE network; a Microbiological Emergency Response Team, which has expertise that has, over the years, been lent to the World Health Organization as well as other countries.