Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.

Join

Subscribe or Register

Existing user? Login

Adverse drug events

Inflammation increases risk of hearing loss with antibiotic treatment

The risk of hearing loss associated with use of aminoglycosides is increased if a patient has an infection that causes inflammation.

Inflammation increases the risk of hearing loss associated with the use of aminoglycoside antibiotics, according to a study. In the image, close-up of an ear

Source: Shutterstock.com

Aminoglycoside antibiotics are known to be associated with hearing loss because they can damage the ear’s sensory cells, but it has not been clear who is at greatest risk

Inflammation increases the risk of hearing loss associated with the use of aminoglycoside antibiotics, according to a study published in Science Translational Medicine[1] on 29 July 2015.

Aminoglycosides, including gentamicin, amikacin, netilmicin and tobramycin, are potent antibiotics, and are important in treating serious bacterial infections such as sepsis, meningitis, peritonitis and pneumonia. Because of their broad-spectrum effect, they are often used as first-line treatment for suspected sepsis in newborn babies, often before infection is confirmed.

Although the ear is protected by a blood-labyrinth barrier, aminoglycosides can cross this barrier and travel into the cochlea where they enter the sensory hair cells through mechano-electrical transducer (MET) channels and kill the hair cells. These cells, which translate sound into electrical signals, cannot regenerate once damaged, and the risk increases with rising dose and longer duration of treatment. While it is known that aminoglycosides can cross into the ear and damage the ear’s sensory cells, it has not been clear who is at greatest risk.

To find out more about how this happens, and why some people are affected more than others, researchers led by Peter Steyger from the Oregon Hearing Research Center, Oregon Health & Science University, Portland, tested the effects of aminoglycosides on mice with symptoms of sepsis and inflammation. They found that low levels of inflammation did not affect how much drug crossed into the ear’s hair cells, but higher levels dilated the capillaries and increased the amount of drug that crossed into the cochlea.

The finding suggests that patients who have a severe infection that causes inflammation, such as sepsis, are at a greater risk of deafness than previously thought.

Understanding more about the process could help tailor treatments to patients, says Corné Kros, professor of neuroscience at the University of Sussex, who wrote an accompanying editorial[2].

“The simplest approach could be to stop using aminoglycosides, but these are tried and tested, and low cost, with a low rate of resistance formation, and there aren’t many alternatives,” says Kros. “In the short term, it will be about being aware, and monitoring patients closely for hearing loss.”

In the longer-term, researchers are developing drugs that could be coadministered with intravenous and intramuscular aminoglycosides that stop their uptake into the hair cells by competing for the MET channels, says Kros. Another approach could be to modify aminoglycosides so that they are less likely to cross the blood-labyrinth barrier, or be taken up into the hair cells, but still retain their antibacterial activity. According to Kros, understanding why some people are more vulnerable to the effects of the glycosides, for example finding biomarkers to be able to personalise treatment, would also help to avoid this life-changing side effect.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20069083

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Pharmacy OSCEs

    Pharmacy OSCEs

    The only pharmacy-specific OSCE revision guide. This easy-to-use book covers the key competencies that will be tested in your exams.

    £25.00Buy now
  • Drugs and the Liver

    Drugs and the Liver

    Drugs and the Liver assists practitioners in making pragmatic choices for their patients. It enables you to assess liver function and covers the principles of drug use in liver disease.

    £38.00Buy now
  • Physicochemical Principles of Pharmacy

    Physicochemical Principles of Pharmacy

    This established textbook covers every aspect of drug properties from the design of dosage forms to their delivery by all routes to sites of action in the body.

    £48.00Buy now
  • Handbook of Pharmaceutical Excipients

    Handbook of Pharmaceutical Excipients

    The Handbook of Pharmaceutical Excipients contains essential data on the physical properties of excipients, their safe use and potential toxicity.

    £415.00Buy now
  • International Research in Healthcare

    International Research in Healthcare

    Guidance for students or researchers undertaking a multi-centre research project in health services, medicines use and professional practice.

    £38.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.