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
• hearing loss
• audiogram
• cystic fibrosis

Acknowledgements

The authors thank the UCSD Adult Cystic Fibrosis Clinic Team for their commitment to the hearing health care of their patients.

Disclosure statement

Dr. Malcolm Gleser is the CEO of Oricula Therapeutics, which is attempting to develop and commercialise ORC-13661, an oral drug for the prevention of ototoxicity associated with parenteral aminoglycoside therapy.

Dr. Erika Zettner does not have personal relationships with organisations that could potentially be perceived as influencing the described research.

All authors have read the journal’s disclosure policy of potential conflicts of interest.