The cumulative effects of intravenous antibiotic treatments on hearing in patients with cystic fibrosis

Angela C. Garinis, Campbell P. Cross, Priya Srikanth, Kelly Carroll, M. Patrick Feeney, Douglas H Keefe, Lisa L. Hunter, Daniel B. Putterman, David M. Cohen, Jeffrey A. Gold, Peter S. Steyger

Research output: Contribution to journalArticle

15 Citations (Scopus)

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 16.0 kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (≤ 25 dB HL for all frequency bands) or hearing loss (> 25 dB 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.

Original languageEnglish (US)
Pages (from-to)401-409
Number of pages9
JournalJournal of Cystic Fibrosis
Volume16
Issue number3
DOIs
StatePublished - May 1 2017

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Cystic Fibrosis
Hearing
Anti-Bacterial Agents
Aminoglycosides
Hearing Loss
Glycopeptides
Vancomycin
Ear
Therapeutics
Hearing Tests
Tobramycin
Amikacin
Sensorineural Hearing Loss
Respiratory Tract Infections

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

The cumulative effects of intravenous antibiotic treatments on hearing in patients with cystic fibrosis. / Garinis, Angela C.; Cross, Campbell P.; Srikanth, Priya; Carroll, Kelly; Feeney, M. Patrick; Keefe, Douglas H; Hunter, Lisa L.; Putterman, Daniel B.; Cohen, David M.; Gold, Jeffrey A.; Steyger, Peter S.

In: Journal of Cystic Fibrosis, Vol. 16, No. 3, 01.05.2017, p. 401-409.

Research output: Contribution to journalArticle

Garinis, AC, Cross, CP, Srikanth, P, Carroll, K, Feeney, MP, Keefe, DH, Hunter, LL, Putterman, DB, Cohen, DM, Gold, JA & Steyger, PS 2017, 'The cumulative effects of intravenous antibiotic treatments on hearing in patients with cystic fibrosis', Journal of Cystic Fibrosis, vol. 16, no. 3, pp. 401-409. https://doi.org/10.1016/j.jcf.2017.01.006
Garinis, Angela C. ; Cross, Campbell P. ; Srikanth, Priya ; Carroll, Kelly ; Feeney, M. Patrick ; Keefe, Douglas H ; Hunter, Lisa L. ; Putterman, Daniel B. ; Cohen, David M. ; Gold, Jeffrey A. ; Steyger, Peter S. / The cumulative effects of intravenous antibiotic treatments on hearing in patients with cystic fibrosis. In: Journal of Cystic Fibrosis. 2017 ; Vol. 16, No. 3. pp. 401-409.
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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 16.0 kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (≤ 25 dB HL for all frequency bands) or hearing loss (> 25 dB 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.",
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AU - Garinis, Angela C.

AU - Cross, Campbell P.

AU - Srikanth, Priya

AU - Carroll, Kelly

AU - Feeney, M. Patrick

AU - Keefe, Douglas H

AU - Hunter, Lisa L.

AU - Putterman, Daniel B.

AU - Cohen, David M.

AU - Gold, Jeffrey A.

AU - Steyger, Peter S.

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N2 - 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 16.0 kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (≤ 25 dB HL for all frequency bands) or hearing loss (> 25 dB 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.

AB - 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 16.0 kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (≤ 25 dB HL for all frequency bands) or hearing loss (> 25 dB 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.

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