Ototoxicity of Aminoglycosides the Modern Concepts

Abstract

Aminoglycosides are broad-spectrum antibacterial agents used in the treatment of urinary tract infections, tuberculosis, visceral leishmaniasis, sepsis in newborns, as well as cystic fibrosis. However, the use of aminoglycosides is limited due to their ototoxicity — the risk of developing serious adverse reactions, in particular, persistent irreversible hearing loss and vestibular disorders associated with the death of hair cells in the inner ear. The review analyzes scientific data on the possible mechanisms of aminoglycosides’ damaging effect on the hair cells of the inner ear. Genetically determined causes contributing to the manifestation of ototoxic properties of drugs of this group are described. The necessity of genetic screening for the carriage of mutations m.1555A>G and m.1494C>T in the MT-RNR1 gene of mitochondrial DNA is substantiated in order to minimize the risk of hearing disorders in patients with hereditary predisposition. Understanding the mechanisms of ototoxicity of aminoglycosides will make it possible to find ways to prevent and correct hearing loss after their use.