Balance Problems After IV Antibiotics: What to Do

Some patients I meet have noticed dizziness and balance problems after IV antibiotics. In this blog, I will give a brief overview of this problem and three helpful next steps.

IV Antibiotics and Balance Problems

I have met patients who started to have dizziness or balance problems after Vanco drips. “Vanco” is short for vancomycin, a strong antibiotic drug that can be given intravenously to resolve a serious infection.

Some patients experienced the onset of dizziness or balance problems after receiving the commonly prescribed antibiotic Gentamicin. Gentamicin can be given intravenously (IV) or by localized injection into the ears.

Vancomycin and Gentamicin are both potentially ototoxic. This means that they can cause permanent, irreversible damage to the inner ear.

Antibiotic medications may be life-saving for some patients. Therefore, it is often necessary, regardless of the possible side effects.

Learn more about the research and physiology of balance problems after IV antibiotics.

Helpful Next Steps

Next Step #1: Talk to Your Doctor

Talk to your doctor if you feel hearing loss, ringing in your ears, dizziness, or balance problems after receiving vancomycin or gentamicin.

For that matter, any other antibiotics ending in “-mycin” should be considered as a possible cause of ototoxicity.

Your doctor can make the right decisions and referrals to protect your ears and balance system from further damage, as much as possible.

Next Step #2: Consult a Vestibular Physical Therapist (VPT)

Antibiotics like vancomycin and gentamicin can possibly affect the function of your vestibular system and thereby cause a new onset of dizziness or disequilibrium.

If you start to notice any balance problems after IV antibiotics, vestibular PT may be able to help.

This may feel like an imbalance or unsteadiness while walking. You may feel worse while moving around, changing positions, walking, or turning your head.

If that sounds like you, I encourage you to consult with a vestibular PT as part of a multidisciplinary approach to support your full recovery.

Click here to search for a Vestibular PT in your area.

Bonus Next Step: Assess your Immune Function for Signs of Immune Deficiency

In my specialized clinical practice for people with dizziness or vertigo, I am always digging into the deepest root causes. For my patients with persistent or recurring infections, an additional step I’m taking is to review a recent CBC or request a CBC from their primary care provider (PCP or GP) to assess their immune response.

Key points for the timing of this test include:

1. The CBC (blood draw) must be done when the infection is believed to be “active.” A CBC before the infection started is not relevant to this analysis.

2. Steroids can mess up these results, so it’s best to get this test done before starting any steroids.

Key points for analysis of results:

If the CBC is “normal,” then we may have a problem. Here are the details:

If their white blood cells are “normal” on the CBC, this means they are NOT elevated at the time of a known active infection… But they should be!

A normal immune response to an infection is to increase the white blood cells to fight the infection.

If I see a normal CBC result in patients with an active infection, then I will make appropriate referrals for medical management of a suspected immune deficiency.

Immune system treatment can include overall support to the immune system. Specific detox protocols exist for certain suspected problems with the immune system, especially if this all started after the patient had a COVID shot or COVID infection.

For more on my observations for the sub-population of these patients with suspected Long COVID, click here.

Most Important Precaution: Don’t Go Swimming at Night

If you notice that you have new balance problems after IV antibiotics, the most important thing to avoid is swimming at night or in the dark.

Gentamicin toxicity is the most common cause of medication-related complete vestibular loss in both ears. Patients with complete bilateral vestibular loss must rely on visual input for swimming.

Patients with complete bilateral vestibular loss are at serious risk of becoming disoriented and drowning if they swim in the dark or submerge completely under water without visual input.

Your doctor or vestibular PT can help you decide if swimming at night is safe for you, based on the results of vestibular testing.