Cystic Fibrosis and Ototoxic Meds Linked with Hearing Loss

Published October 2021 | American Journal of Audiology

Aminoglycoside antibiotics such as gentamicin, amikacin and tobramycin—often used to treat infections in children and adults with cystic fibrosis (CF)—are known to have an ototoxic effect. Lisa Hunter, PhD, scientific director of the Division of Audiology, led one of the first studies to evaluate the functional impact of this ototoxicity.

Not only do those with CF have a higher prevalence of hearing loss, they also are more likely to have impaired speech-in-noise understanding, balance problems and tinnitus compared to typically developing controls. Almost half the CF patients had a history of middle ear infections, despite frequently receiving antibiotics.

The study concludes that children with CF should be asked about these symptoms and have a baseline hearing assessment before being treated with aminoglycosides, and then be assessed regularly so that hearing problems can be identified and treated.

“Due to medical advancements, individuals with CF are living longer,” Hunter said. “Therefore, they are at a higher risk for developing hearing loss that can progress and ultimately impact speech and language skills, literacy development, scholastic achievement and quality of life.”

The study was originally funded by a Cincinnati Children’s Place Award, and has been expanded into a larger multisite study, “Prevention of Ototoxicity with Effective Monitoring or POEM,” funded by a five-year NIH grant.

“We are collaborating with Dr. Gary McPhail, director of the cystic fibrosis program, Dr. Sander Vinks and Dr. Min Dong in clinical pharmacology, and Drs. Patrick Feeney and Angela Garinis at Oregon Health and Science University in Portland,” Hunter said. “We hope to validate and refine monitoring tools for use in the clinic.”