No drug approvals or recalls affecting ENT in today's sweep. What did publish is a pharmacogenomics guideline from the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics, on MT-RNR1 genotype testing to prevent aminoglycoside-mediated ototoxicity.
The MT-RNR1 variant is maternally inherited and carriers can lose hearing profoundly and permanently after a single standard dose of an aminoglycoside. It is one of the few genuinely actionable pharmacogenomic associations in this specialty: the test result changes the drug, and the harm it prevents is irreversible.
The practical question a guideline like this raises is turnaround. Genotyping is only useful before the dose, and aminoglycosides are frequently given urgently — in neonatal sepsis, in febrile neutropenia, in the situations where waiting for a result is not an option. Point-of-care testing has been the enabling technology where this has been implemented, and its availability is what decides whether a recommendation like this is practice or paperwork.
For Indian practice this is worth reading despite being UK guidance. Aminoglycoside use is higher here, driven by cost and by resistance patterns that keep amikacin and gentamicin in frequent use, and the family history question — deafness after an injection in a maternal relative — costs nothing and is the screening tool available everywhere.
- Ask about deafness in maternal relatives after an injection before prescribing an aminoglycoside — it costs nothing.
- Genotyping only helps before the first dose; check what turnaround your laboratory can actually offer.
- The harm is permanent and can follow a single standard dose — this is not a cumulative-toxicity issue.
- No drug approvals or recalls affecting ENT in today's sweep.
- Relevant beyond the UK: aminoglycoside exposure is higher where cost and resistance drive prescribing.
The statistics, in plain English
A pharmacogenomic guideline reports no effect size of its own. The concept to understand is penetrance: MT-RNR1 variants raise the risk of ototoxicity sharply but not universally, so a positive genotype identifies someone who may be harmed rather than someone who certainly will be. Because the variant is mitochondrial it is inherited only from the mother, which is what makes the family history question specific — a maternal relative who went deaf after an injection is meaningful, a paternal one is not.
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