title: The cumulative effects of intravenous antibiotic treatments on hearing in patients with cystic fibrosis.
abstract: BACKGROUND
  Aminoglycosides (AGs) and glycopeptides are antibiotics essential for treating life-threatening respiratory infections in patients with cystic fibrosis (CF). The goal of this study was to examine the effects of cumulative intravenous (IV)-AG (amikacin and/or tobramycin) and/or glycopeptide (vancomycin) dosing on hearing status in patients with CF.
  
  
  METHODS
  Hearing thresholds were measured from 0.25 to 16.0kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (≤25dB HL for all frequency bands) or hearing loss (>25dB HL for any frequency band in either ear). Participants were also characterized into quartiles by their cumulative IV-AG (with or without vancomycin) exposure. Dosing was calculated using two strategies: (i) total number of lifetime doses, and (ii) total number of lifetime doses while accounting for the total doses per day. This was referred to as the "weighted" method.
  
  
  RESULTS
  Participants in the hearing loss group were significantly older than those in the normal-hearing group. After adjusting for gender and age at the time of hearing test, participants in the two highest-quartile exposure groups were almost 5 X more likely to have permanent sensorineural hearing loss than those in the two lowest-quartile exposure groups. There was a small group of CF patients who had normal hearing despite high exposure to IV-antibiotics.
  
  
  CONCLUSIONS
  Cumulative IV-antibiotic dosing has a significant negative effect on hearing sensitivity in patients with CF, when controlling for age and gender effects. A trend for increasing odds of hearing loss was associated with increasing cumulative IV-antibiotic dosing.
authors.affiliation: Otolaryngology, Oregon Health & Science University, Portland, OR, United States; National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR, United States. Electronic address: garinis@ohsu.edu.
authors.forename: Angela C
authors.initials: AC
authors.lastname: Garinis
authors.affiliation: Otolaryngology, Oregon Health & Science University, Portland, OR, United States; School of Medicine, Oregon Health & Science University, Portland, OR, United States.
authors.forename: Campbell P
authors.initials: CP
authors.lastname: Cross
authors.affiliation: Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR, United States.
authors.forename: Priya
authors.initials: P
authors.lastname: Srikanth
authors.affiliation: Otolaryngology, Oregon Health & Science University, Portland, OR, United States.
authors.forename: Kelly
authors.initials: K
authors.lastname: Carroll
authors.affiliation: Otolaryngology, Oregon Health & Science University, Portland, OR, United States; National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR, United States.
authors.forename: M Patrick
authors.initials: MP
authors.lastname: Feeney
authors.affiliation: Boys Town National Research Hospital, Omaha, NE, United States.
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Keefe
authors.affiliation: Cincinnati Children's Hospital, Cincinnati, OH, United States.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Hunter
authors.affiliation: Otolaryngology, Oregon Health & Science University, Portland, OR, United States; National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR, United States.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Putterman
authors.affiliation: Nephrology, Oregon Health & Science University, Portland, OR, United States.
authors.forename: David M
authors.initials: DM
authors.lastname: Cohen
authors.affiliation: Pulmonology, Oregon Health & Science University, Portland, OR, United States.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Gold
authors.affiliation: Otolaryngology, Oregon Health & Science University, Portland, OR, United States.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Steyger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000583:Amikacin / Q000008:administration & dosage / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone / Q000379:methods; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D034381:Hearing Loss / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012737:Sex Factors; D013995:Time; D014031:Tobramycin / Q000008:administration & dosage / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D000583:Amikacin; D014031:Tobramycin