Ototoxicity in cystic fibrosis patients receiving intravenous tobramycin for acute pulmonary exacerbation: Ototoxicity following tobramycin treatment.

Autor: Harruff EE; Sound Pharmaceuticals, Inc., 4010 Stone Way N, Ste 120, Seattle, WA, 98103, United States., Kil J; Sound Pharmaceuticals, Inc., 4010 Stone Way N, Ste 120, Seattle, WA, 98103, United States. Electronic address: eharruff@soundpharma.com., Ortiz MGT; University of Miami Pulmonary Research Center, 1321 NW 14th St, Ste 606-607, Miami, FL, 33136, United States., Dorgan D; Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, United States., Jain R; University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, United States., Poth EA; Medical University of South Carolina, 96 Jonathan Lucas St, Ste 816 CSB, MSC 630, Charleston, SC, 29425, United States., Fifer RC; University of Miami Pulmonary Research Center, 1321 NW 14th St, Ste 606-607, Miami, FL, 33136, United States., Kim YJM; Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, United States., Shoup AG; University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, United States., Flume PA; Medical University of South Carolina, 96 Jonathan Lucas St, Ste 816 CSB, MSC 630, Charleston, SC, 29425, United States.
Jazyk: angličtina
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2021 Mar; Vol. 20 (2), pp. 288-294. Date of Electronic Publication: 2020 Dec 16.
DOI: 10.1016/j.jcf.2020.11.020
Abstrakt: Aminoglycosides are commonly used to treat infections in CF patients and are highly ototoxic. The incidence of tobramycin-induced hearing loss, tinnitus, vertigo or dizziness (ototoxicity) varies widely from 0 to 56% secondary to variation in patient enrollment, dosing, audiometry, and ototoxic criteria. The aim of this study is to determine the incidence of ototoxicity after one course of once-daily IV tobramycin in CF patients. Adult CF patients with acute pulmonary exacerbations were enrolled on IV tobramycin (10 mg/kg/d, ≥10 days). Pure-tone audiometry was performed for standard and extended high frequencies in the sensitive range for ototoxicity (SRO). American-Speech-Language-Hearing-Association cochleotoxicity criteria were applied. Distortion product otoacoustic emissions (DPOAE) and the words-in-noise-test (WINT) were assessed. Tinnitus Functional Index (TFI) and Vertigo Symptoms Scale (VSS) were used. Eighteen CF patients, mean age 31.1 (18-59), were enrolled. The incidence of cochleotoxic change from baseline at 2 and 4 weeks post-treatment was 89% and 93%. For DPOAE, a measure of outer hair-cell function, the incidence of ≥5 dB decrease was 82% and 80%. For WINT, a measure of word recognition, the incidence of ≥10% decrease was 17% and 40%. For TFI, the incidence of ≥10pt increase was 12% and 8%, and for VSS, the incidence of ≥6pt increase was 0% and 8%. One course of IV tobramycin was sufficient to cause hearing loss and other ototoxic symptoms four weeks after treatment ended. Audiometric measures were more sensitive to ototoxic change than TFI & VSS. Age and duration of tobramycin treatment were not obvious factors for predicting ototoxicity.
(Copyright © 2020. Published by Elsevier B.V.)
Databáze: MEDLINE
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