Prevalence of hearing and vestibular loss in cystic fibrosis patients exposed to aminoglycosides

Handelsman, Jaynee A.; Nasr, Samya Z.; Pitts, Crystal; King, W. M.

doi:10.1002/ppul.23763

Cited by 28 publications

(24 citation statements)

References 37 publications

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“…93 CF patients may be more prone to the vestibular toxicity of inhaled amikacin due to chronic exposure to parenteral aminoglycosides to treat Pseudomonas infections. 94 In the CONVERT study, which enrolled patients with amikacin-susceptible MAC as well as sputum positivity despite at least 6 months of guideline-based therapy (GBT), 29% of patients in the ALIS-GBT arm compared with 8.9% in the GBT-only arm achieved culture conversion. Patients with CF were excluded from this study; however, 62.5% had underlying bronchiectasis, which allows for some extrapolation between the two groups.…”

Section: Drugs Of Emerging Efficacy Inhaled Amikacinmentioning

confidence: 99%

Nontuberculous Mycobacteria in Cystic Fibrosis

Richards

Olivier

2019

Semin Respir Crit Care Med

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Over the past decade, the incidence of nontuberculous mycobacterial (NTM) infection has been increasing in cystic fibrosis patients. Along with this have come a host of complications and burdens to patients that threaten longevity and quality of life. The two main constituents of NTM pulmonary disease, Mycobacterium avium complex (MAC) and M. abscessus, are notoriously difficult to treat with suboptimal clinical responses and are accompanied by high treatment burdens for patients. This review aims to summarize the current knowledge of NTM epidemiology, pathogenesis, professional society guidelines for diagnosis and treatment, and the efficacy of current management recommendations, with attention to cystic fibrosis patients. We go on to examine drugs of emerging but unknown efficacy in clinical use to provide a comprehensive assessment of the current state of management of NTM for cystic fibrosis patients.

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Section: Drugs Of Emerging Efficacy Inhaled Amikacinmentioning

confidence: 99%

Nontuberculous Mycobacteria in Cystic Fibrosis

Richards

Olivier

2019

Semin Respir Crit Care Med

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“…Gentamicin has, e.g., been reported to be associated with no safe serum level for vestibulotoxicity [ 5 ]. In a prospective study of patients receiving variable dosing of aminoglycosides, vestibular dysfunction was reported to be more frequent than auditory dysfunction [ 18 ].…”

Section: Aminoglycoside Antibioticsmentioning

confidence: 99%

Pharmacological intervention in the field of ototoxicity

Laurell

2019

HNO

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Modern research on ototoxicity goes back to the 1940s, when streptomycin was introduced into clinical practice. Today, aminoglycoside antibiotics and platinum-based chemotherapy, mainly cisplatin, are the most important drugs that damage the inner ear and cause hearing loss. The mode of drug administration as well as drug characteristics influence the likelihood that adequate monitoring of drug pharmacokinetics can be performed. It is not possible to predict the individual risk of treatment with an ototoxic drug, but identification of high-risk treatment protocols is important. There are many studies ongoing with the aim of discovering and developing drugs to treat different types of inner ear disorders. The mechanisms of ototoxicity and subsequent loss of hearing function have been mapped in various experimental models and have provided us with useful information for developing protective treatment. When an ototoxic lesion is established, restoration of hearing function becomes more difficult. For both aminoglycoside antibiotics and cisplatin, a large number of otoprotectors have been suggested. Systemic co-administration of an otoprotector would be the easiest approach to avoid ototoxicity in patients but it may negatively affect the intended pharmacotherapeutic aim of the ototoxic drug. New pharmacological formulations are being developed for local otoprotective treatment. This short review focuses on results from clinical reports on otoprotection in patients treated with aminoglycoside antibiotics and cisplatin. So far there is limited evidence for the safe management of otoprotection in patients. Further high-quality studies are needed to provide reliable data on the safety and effectiveness of pharmacological interventions to reduce drug-induced hearing loss.

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“…In a retrospective single‐center study of 71 patients 30 days to 18 years of age, the rate of acute kidney injury was significantly higher in patients receiving Piperacillin‐tazobactam (55%) compared to those receiving cefepime (13%) in addition to tobramycin and vancomycin . In a single‐center study of CF patients over 8 years of age who had been on aminoglycosides, 23% had hearing loss on audiologic evaluation . However, evaluation of the vestibular system showed that 79% had involvement, leading to a recommendation for addition of vestibular evaluation in patients receiving aminoglycosides.…”

Section: Extrapulmonary Complicationsmentioning

confidence: 99%