Aminoglycoside antibiotics cochleotoxicity in paediatric cystic fibrosis (CF) patients: A study using extended high-frequency audiometry and distortion product otoacoustic emissions.
Despite known ototoxic effects of aminoglycoside (AG) antibiotics, audiological assessment is not routinely undertaken in UK CF patients. Consequently, the incidence of hearing loss is not well established.


OBJECTIVE
To document the incidence of hearing loss in cystic fibrosis (CF) children.


METHODS
Hearing function of 45 children from Great Ormond Street Hospital was assessed using pure-tone audiometry up to 20kHz and DPOAEs up to 8kHz.


METHODS
39/45 of participants had received intravenous (IV) AGs, 23 of which received repeated IV AGs every 3 months.


RESULTS
In this high exposure group, 8 (21%) had clear signs of ototoxicity; average 8-20kHz thresholds were elevated by ∼50dB and DPOAE amplitudes were >10dB lower at f2 3.2-6.3 kHz. The remaining 31/39 (79%) of AG exposed patients had normal, even exceptionally good hearing. The 21% incidence of ototoxicity we observed is substantial and higher than previously reported. However, our finding of normal hearing in children with equal AG exposure strongly suggests that other unknown factors, possibly genetic susceptibility, influence this outcome.


CONCLUSIONS
We recommend comparable auditory testing in all CF patients with high AG exposures. Genetic analysis may help explain the dichotomy in response to AGs found.
The Ear Institute, UCL, London, UK. g.al-malky@ucl.ac.uk
Ghada
G
Al-Malky
Ranjan
R
Suri
Sally J
SJ
Dawson
Tony
T
Sirimanna
David
D
Kemp
D000293:Adolescent; D000617:Aminoglycosides / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001300:Audiometry, Evoked Response; D001301:Audiometry, Pure-Tone; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D034381:Hearing Loss / Q000139:chemically induced*; D006801:Humans; D008297:Male; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000209:etiology
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents