INTRODUCTION Aminoglycoside (AG) antibiotics, such as tobramycin, are known to be ototoxic but important clinically due to their bactericidal efficacy. Persons with cystic fibrosis (CF) are at risk for AG-induced ototoxicity due to the repeated use of intravenous (IV) tobramycin for the treatment of pulmonary exacerbations. While it is well-established that ototoxic hearing loss is highly prevalent in this clinical population, the progression of hearing loss over time remains unclear. Cumulative IV-AG dosing has been associated with a higher risk of ototoxic hearing loss, yet some individuals lose substantial hearing after a single IV-AG treatment, while others never seem to lose hearing. METHODS 31 persons with CF (18 on IV tobramycin, 13 controls) were enrolled in an observational study. Pure-tone hearing thresholds (0.25-16 kHz) were measured at baseline (pre-treatment) and at follow-up for each subject. A hearing shift was determined using various metrics, and outcomes were compared to characterize changes in hearing bilaterally for both study groups. RESULTS Comparison of pure-tone threshold shifts between baseline and follow-up audiograms following either a course of IV tobramycin (n = 18) or no intervening therapy (n = 13) demonstrated significant (p < 0.05) threshold shifts in all continuous metrics tested. CONCLUSION A single course of IV tobramycin causes ototoxic hearing loss in some people with CF, which supports the need for routine ototoxicity monitoring and management in this clinical population. These findings also suggest that people with CF are a suitable population for clinical trials examining ototherapeutics in single IV-tobramycin treatment episodes.

中文翻译：

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单疗程静脉注射妥布霉素后囊性纤维化患者耳毒性的前瞻性队列研究

引言 氨基糖苷类 (AG) 抗生素，如妥布霉素，已知具有耳毒性，但因其杀菌功效而在临床上很重要。由于反复使用静脉内 (IV) 妥布霉素治疗肺部恶化，患有囊性纤维化 (CF) 的人有发生 AG 引起的耳毒性的风险。虽然众所周知，耳毒性听力损失在该临床人群中非常普遍，但听力损失随时间的进展仍不清楚。累积 IV-AG 剂量与较高的耳毒性听力损失风险相关，但有些人在单次 IV-AG 治疗后会失去大量听力，而另一些人似乎从未失去听力。方法 31 名 CF 患者（18 名静脉注射妥布霉素，13 名对照）参加了一项观察性研究。纯音听阈 (0. 25-16 kHz）在基线（治疗前）和每个受试者的随访时测量。使用各种指标确定听力变化，并比较结果以表征两个研究组的双侧听力变化。结果 在静脉注射妥布霉素 (n = 18) 或无干预治疗 (n = 13) 后，基线和后续听力图之间纯音阈值变化的比较表明，在所有测试的连续指标中阈值变化显着 (p < 0.05) . 结论 单次静脉注射妥布霉素会导致一些 CF 患者出现耳毒性听力损失，这支持了对这一临床人群进行常规耳毒性监测和管理的必要性。