Occurrence and Risk of Cochleotoxicity in Cystic Fibrosis Patients Receiving Repeated High-Dose Aminoglycoside Therapy

Mulheran, M.; Degg, C.; Burr, Steven W.; Morgan, Douglas W.; Stableforth, D E

doi:10.1128/aac.45.9.2502-2509.2001

Cited by 90 publications

(106 citation statements)

References 34 publications

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“…day -1 of tobramycin [102] and netilmicin [120] has been associated with symptoms of dizziness after the antibiotic infusion. However, surprisingly few side-effects have been reported in high dose aminoglycoside therapy [89,121,122]. Nevertheless, it is necessary to monitor ototoxicity and renal function and adjust the dosage interval accordingly, early in therapy [64].…”

Section: Intravenous Antipseudomonal Antibiotic Therapy In Cystic Fibmentioning

confidence: 99%

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

Döring¹,

Conway²,

Heijerman³

et al. 2000

Eur Respir J

557

478

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Cystic fibrosis (CF) is the most common lethal hereditary disorder with autosomal recessive heredity in caucasians. The majority of CF patients suffer from chronic respiratory infection with the opportunistic bacterial pathogen Pseudomonas aeruginosa. No consensus among clinicians has been reached so far concerning antibiotic treatment against P. aeruginosa in CF patients.Consensus answers to 24 important questions in this context, based on current evidence, are presented, given by a panel of 34 European experts. Questions addressed and answered are: The diagnosis of P. aeruginosa lung colonization in CF; The impact of P. aeruginosa on the clinical state of CF patients; The assessment of P. aeruginosa susceptibility against antibiotics and the importance of these results for the clinician; The use of monotherapy versus combination therapy; The development of microbial resistance; The achievement of optimal airway concentrations; The effects of subinhibitory concentrations of antibiotics on P. aeruginosa; Statements on the pharmacokinetics of antibiotics in CF patients; Recommendations for doses and dosing intervals and length of treatment regimens; and Toxic side effects due to repeated antibiotic therapy was addressed.The expert panel answered further questions on the use of fluoroquinolones in children with CF, on the administration of nebulized antibiotics and whether prevention of P. aeruginosa lung colonization is possible in CF using antibiotic therapy.Problems of antibiotic therapy at home and in the hospital were addressed, a consensus statement on regular maintenance treatment, or treatment on demand, was given and different routes of administration of antibiotics were recommended for different clinical situations.Finally, the factors which determine the choice of the antibiotic, the dosage, and the duration of the treatment in cystic fibrosis patients were addressed and the design of future antibiotic studies in the context of Pseudomonas aeruginosa lung infection in cystic fibrosis patients were recommended. Eur Respir J 2000; 16: 749±767.

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Section: Intravenous Antipseudomonal Antibiotic Therapy In Cystic Fibmentioning

confidence: 99%

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

Döring¹,

Conway²,

Heijerman³

et al. 2000

Eur Respir J

557

478

View full text Add to dashboard Cite

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“…Due to the chronicity of the lung infection, the severity of structural damage and the poorer penetration of drugs through thick mucosa, larger doses of antibiotics are required to treat CF PExs than in other groups of patients with lung infections. 1,3 Frequent and longer courses of IV treatment, particularly with aminoglycosides, has now been shown to be associated with renal impairment, 4,5 autotoxicity 6,7 as well as increased rate of antibiotic allergy. 8 In addition, extension of duration of IV antibiotic treatment is associated with added volume of work to patients, CF care workers and in incremental cost pressure of CF care.…”

Section: Introductionmentioning

confidence: 99%

Extending the course of intravenous antibiotics in adult patients with cystic fibrosis with acute pulmonary exacerbations

Sequeiros

Jarad

2012

Chron Respir Dis

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“…Drugs such as neomycin, tobramycin, kanamycin, streptomycin, amikacin, and gentamicin can affect hearing, balance, or both (Clark 1977;Xie et al 2011;Ahmed et al 2012). Despite potential ototoxicity and nephrotoxicity, aminoglycosides remain a drug of choice for use against gramnegative bacteria (see Xie et al 2011;Mulheran et al 2001;Hanberger et al 2013;Edson and Terrell 1999). Aminoglycoside antibiotics are also widely used to treat multidrug-resistant tuberculosis (MDR-TB).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Nutrient Supplement to Reduce Gentamicin-Induced Ototoxicity

Prell

Ojano-Dirain

Rudnick

et al. 2014

JARO

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Gentamicin is an aminoglycoside antibiotic used to treat gram-negative bacterial infections. Treatment with this antibiotic carries the potential for adverse side effects, including ototoxicity and nephrotoxicity. Ototoxic effects are at least in part a consequence of oxidative stress, and various antioxidants have been used to attenuate gentamicin-induced hair cell death and hearing loss. Here, a combination of nutrients previously shown to reduce oxidative stress in the hair cells and attenuate hearing loss after other insults was evaluated for potential protection against gentamicin-induced ototoxicity. Guinea pigs were maintained on a nutritionally complete standard laboratory animal diet or a diet supplemented with β-carotene, vitamins C and E, and magnesium. Three diets with iterative increases in nutrient levels were screened; the final diet selected for study use was one that produced statistically reliable increases in plasma levels of vitamins C and E and magnesium. In two separate studies, significant decreases in gentamicin-induced hearing loss at frequencies including 12 kHz and below were observed, with less benefit at the higher frequencies. Consistent with the functional protection, robust protection of both the inner and outer hair cell populations was observed, with protection largely in the upper half of the cochlea. Protection was independently assessed in two different laboratories, using two different strains of guinea pigs. Additional in vitro tests did not reveal any decrease in antimicrobial activity with nutrient additives. Currently, there are no FDA-approved treatments for the prevention of gentamicin-induced ototoxicity. The current data provide a rationale for continued investigations regarding translation to human patients.

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Occurrence and Risk of Cochleotoxicity in Cystic Fibrosis Patients Receiving Repeated High-Dose Aminoglycoside Therapy

Cited by 90 publications

References 34 publications

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

Extending the course of intravenous antibiotics in adult patients with cystic fibrosis with acute pulmonary exacerbations

Assessment of Nutrient Supplement to Reduce Gentamicin-Induced Ototoxicity

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