Tobramycin ototoxicity. Repeated courses of high dosage treatment in children with cystic fibrosis

The role of routine hearing screening in children with cystic fibrosis on aminoglycosides: A systematic review

“…Of these initial 75 studies, 63 studies did not meet inclusion criteria and were excluded. A total of 12 articles were included in the final review (Table ) . Three of the 12 articles also studied adult CF patients.…”

“…All studies were carried out at single institutions except for Mulheran et al, which was a multicenter study. Eight of 12 studies (66.7%) utilized statistical analysis . A comprehensive overview of the studies is presented in Table .…”

Cumulative and acute toxicity of repeated high-dose tobramycin treatment in cystic fibrosis

“…The value of tobramycin in the treatment of chronic P. aeruginosa lung infection in CF is well documented (7,8,13,14,22,38,42). Because of a low ratio between therapeutic and toxic levels, a major limitation in the use of aminoglycosides is the development of nephro-and acousticovestibular toxicity (3,17).…”

“…Whereas the acute nephro-and acousticovestibular toxicity of tobramycin is well known (17,25), knowledge of possible cumulative toxicity of repeated courses of tobramycin is less and largely limited to experience with CF patients (7,31,38).…”

Side effects of aminoglycosides on the kidney, ear and balance in cystic fibrosis

“…Two studies have systematically screened for vestibulotoxicity in CF. Thomsen et al reported a study of 53 patients with a mean age of 11.8 years who had received a mean of 3.2 courses of tobramycin 46. A differential caloric test was performed and, in this series, no patients had an abnormal result.…”