Skip to main content
Log in

Aminoglycoside induced ototoxicity in patients with cystic fibrosis

  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Summary

The improved survival of cystic fibrosis (CF) patients is partly due to intensive treatment for their chronic infections. Treatment usually includes intravenous and nebulised aminoglycoside antibiotics and they receive a large cumulative dose of these antibiotics over their lifetime. There is little information in the literature on the prevalence of ototoxicity due to aminoglycoside in these patients.

We performed pure tone auditometry on 43 CF patients aged 14–42 years. Seven (16%) had bilateral sensorineural hearing loss (SNHL) for high frequency sounds, consistent with aminoglycoside induced ototoxicity. However, only 2 of these patients had documented toxic serum levels in the past.

The identification of bilateral SNHL in one in six adult CF patients is a cause for concern. It may be that the high cumulative dose of aminoglycosides received by these patients may be causing inner ear injury in the absence of specific episodes of toxic serum levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. De Arce, M. Mulherin, D., McWilliams, P., Lawler, M., FitzGerald, M. X., Humphries, P. Frequency of deletion 508 among Irish cystic fibrosis patients. Hum. Gen. 1990: 85, 403–404.

    Article  CAS  Google Scholar 

  2. Nevin, G. B., Nevin, N. C., Redmond, A. O. Prevalence and survival of patients with cystic fibrosis in Northern Ireland, 1961-1971. Ulster Med. J. 1983: 52, 153–156.

    PubMed  CAS  Google Scholar 

  3. Gibson, L. E., Cooke, R. E. A test for concentration of electrolytes in sweat in cystic fibrosis of the pancreas utilising pilocarpine by iontophoresis. Pediatrics 1959: 23, 545–549.

    PubMed  CAS  Google Scholar 

  4. Phelan, P. D., Hey, E. Cystic fibrosis mortality in England and Wales and in Victoria, Australia 1976-1980. Arch. Dis. Child. 1984: 59, 71–73.

    PubMed  CAS  Google Scholar 

  5. Corey, M. L. Longitudinal studies in cystic fibrosis. In: Perspectives in Cystic Fibrosis, Sturgess, J. M. (ed.). Proceedings of the 8th International CF Congress, Toronto, Canada. Canadian CF Foundation. Toronto: 1980: 246–255.

    Google Scholar 

  6. Neilsen, O. H., Schiotz, P. O. Cystic fibrosis in Denmark in the period 1945-1981. Evaluation of centralised treatment. Acta Paediatr. Scand. [Supp.] 1982: 301, 107–119.

    Article  Google Scholar 

  7. Penketh, A. R. L., Wise, A., Meams, M. B., Hodson, M. E., Batten, J. C. Cystic fibrosis in adolescents and adults. Thorax. 1987: 42, 526–532.

    Article  PubMed  CAS  Google Scholar 

  8. Keams, G. L., Hilman, B. C., Wilson, J. T. Dosing implications of altered gentamicin desposition in patients with cystic fibrosis. J. Pediatr. 1982: 100, 312–218.

    Article  Google Scholar 

  9. Kelly, H. B., Menendez, R., Leland, F., Murphy, S. Pharmacokinetics of tobramycin in cystic fibrosis. J. Pediatr. 1982: 100, 318–321.

    Article  PubMed  CAS  Google Scholar 

  10. Buring, J. E., Evans, D. A., Mayrent, S. L., Rosner, B., Colton, T., Hennekens, C. H. Randomised trials of arninoglycoside antibiotics: quantitative overview. Rev. Infect Dis. 1988: 10, 951–957.

    PubMed  CAS  Google Scholar 

  11. Crifo, S., Antonelli, M., Gagliardi, M., Lucarelli, N., Marcolini, P. Ototoxicity of aminoglycoside antibiotics in long-tenn treatment of cystic fibrosis. Int J. Pediatr. Otorhinolalyngol. 1980: 2, 251–253.

    Article  CAS  Google Scholar 

  12. Morgan, D. W., Pearman, K., Shenoi, P. M., Stableforth, D. Ototoxicity in adult cystic fibrosis: relationship to aminoglycoside blood levels, total dose, and duration of treatment. Thorax. 1988: 43, 236P.

    Google Scholar 

  13. Hjelte, L., Karlson, K., Gleisner, L., Strandvik, B. Hearing in relation to aminoglycoside dosage in cystic fibrosis. 10th International Cystic Fibrosis Congress, Sydney, Australia. Excerpta Medica, Hong Kong: 1988: 107.

    Google Scholar 

  14. Byrne, J. E., Kerr, A. G. Sensorineural hearing loss. In: Scott-Brown’s Otolaryngeal, Volume 3, Kerr, A. G., Groves, J. (eds.). Fifth edition. Butterworth and Co. (Publishers) Ltd., London. 1987: 381–386.

    Google Scholar 

  15. Diamond, C. Ear, nose and throat disorders. In: Textbook of adverse drug reactions, Davies, D. M. (ed.). Third edition. Oxford University Press. Oxford. 1085: 530–548.

    Google Scholar 

  16. Moffat, D. A. Ototoxicity. In: Scott-Brown’s Otolaryngeal, Volume 3, Kerr, A. G., Groves, J. (eds.). Fifth edition. Butterworth and Co. (Publishers) Ltd., London. 1987: 465–499.

    Google Scholar 

  17. Stupp, H., Kupper, F., Lagler, F., Sous, H., Quante, M. Inner ear concentrations and ototoxicity of different antibiotics in local and systemic application. Audiology 1973: 12, 350–363.

    Article  PubMed  CAS  Google Scholar 

  18. Hawkins, J. E. Ototoxic mechanisms: a working hypothesis. Audiology 1973: 12, 383–393.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mulherin, D., Fahy, J., Grant, W. et al. Aminoglycoside induced ototoxicity in patients with cystic fibrosis. I.J.M.S. 160, 173–175 (1991). https://doi.org/10.1007/BF02961666

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02961666

Keywords

Navigation