Negative hearing effects of a single course of IV aminoglycoside therapy in cystic fibrosis patients

Abstract

Objective: Identify hearing effects of a single course of intravenous (IV) aminoglycoside antibiotics (AGs) therapy in adult cystic fibrosis (CF) patients. Determine whether the change is large enough to enable a proof-of-concept study of a new drug preventing AG-associated hearing loss.

Design: Retrospective case review of CF patients with sequential audiograms ± an intervening course of IV AG therapy.

Study sample: 84 patients with no intervening IV AG treatment, 38 patients undergoing a single course of IV AGs.

Results: Using ASHA ototoxicity metrics, 45% of adult CF patients in the Single-IV group met the criteria for ototoxicity compared to 23% of the No-IV patients. Other hearing metrics including the average maximal threshold shift (TS) and average high frequency TS showed highly significant differences between groups. Testing only participants with mild or greater pre-therapy high frequency hearing loss further increased the differences between the two groups by every metric tested.

Conclusion: Adult CF patients exposed to a single course of IV AGs have significantly greater TS than patients without IV AG exposure. Patients with mild to moderate hearing loss prior to AG-IVs are at increased risk of developing ototoxicity from subsequent parenteral AG therapy.

Keywords: Ototoxicity; aminoglycoside; audiogram; cystic fibrosis; hearing loss.