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Vestibulotoxicity as a consequence of systemically administered tobramycin in cystic fibrosis patients

Renske J Scheenstra1, Evert Rijntjes, Dénes L J Tavy

  • 1Department of Head and Neck Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam,The Netherlands. r.scheenstra@nki.nl

Acta Oto-Laryngologica
|July 9, 2008
PubMed
Abstract

Insights

Cystic fibrosis patients exposed to tobramycin show a 30.4% prevalence of vestibulotoxicity, indicating a need for screening. Further research is needed to establish specific evidence-based recommendations for monitoring tobramycin

Area of Science:

  • Otolaryngology
  • Pulmonology
  • Pharmacology

Background:

  • Cystic fibrosis (CF) management often involves aminoglycoside antibiotics like tobramycin.
  • The ototoxic and vestibulotoxic potential of tobramycin is a known concern.
  • Previous research has not specifically investigated tobramycin-induced vestibulotoxicity in CF patients.

Purpose of the Study:

  • To determine the prevalence of tobramycin-induced vestibulotoxicity in adult cystic fibrosis patients.
  • To assess the utility of subjective dizziness questionnaires and physical examination in detecting tobramycin-induced vestibulotoxicity.

Main Methods:

  • Observational cohort study including 23 adult CF patients exposed to systemic tobramycin.
  • Assessment of subjective dizziness via validated questionnaires.
  • Vestibular symptom evaluation through physical examination and electronystagmography (ENG) with caloric irrigation as the gold standard.

Main Results:

  • Peripheral vestibular loss was identified in 30.4% (7/23) of patients.
  • One patient exhibited central vestibular loss.
  • Subjective questionnaires and physical exams did not reliably predict ENG findings; no age- or dose-related predictive factors were identified.

Conclusions:

  • The high prevalence of vestibulotoxicity (30.4%) in CF patients treated with tobramycin warrants consideration for routine screening.
  • Current subjective and physical examination methods are insufficient for detecting tobramycin-induced vestibulotoxicity.
  • Further prospective longitudinal studies are necessary to develop evidence-based screening protocols.

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