Vestibulotoxicity as a consequence of systemically administered tobramycin in cystic fibrosis patients.
CONCLUSIONS
The reported prevalence of vestibulotoxicity (30.4%) in cystic fibrosis (CF) patients supports vestibulotoxicity screening in CF patients during or after tobramycin exposure. Prospective longitudinal investigation is required for a more specific evidence-based proposal.


OBJECTIVE
To investigate the prevalence of tobramycin-induced vestibulotoxicity in CF patients, as it had not been investigated before.


METHODS
In this observational cohort study, 23 CF patient volunteers from the Haga Teaching Hospital Adult CF centre who had been exposed to at least one treatment with systemically administered tobramycin were included. Subjective feelings of dizziness were measured using validated questionnaires and vestibular symptoms were assessed by physical examination. Electronystagmography (ENG) with caloric irrigation was used as the gold standard.


RESULTS
Peripheral vestibular loss was found in seven patients (7/23 = 30.4%). Central vestibular loss was found in one patient. Analysis of the 19 completed questionnaires showed that 12 patients (12/19 = 63.2%) did not experience dizziness and 3 patients (3/19 = 15/8%) experienced specific vestibular symptoms. The results of the questionnaire could not predict the results of ENG with caloric irrigation. Physical examination showed no abnormalities in any patients. No age- or dose-related predictive factors were found.
Scheenstra
Renske J
RJ
Department of Head and Neck Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam,The Netherlands. r.scheenstra@nki.nl
Rijntjes
Evert
E
Tavy
Dénes L J
DL
Kingma
Herman
H
Heijerman
Harry G M
HG
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000633:toxicity*; D002150:Caloric Tests; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000188:drug therapy*; D004244:Dizziness / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004584:Electronystagmography / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000139:chemically induced; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy*; D014031:Tobramycin / Q000008:administration & dosage / Q000633:toxicity*; D015837:Vestibular Diseases / Q000139:chemically induced* / Q000175:diagnosis; D014722:Vestibule, Labyrinth / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D014031:Tobramycin