Clinical Considerations for Routine Auditory and Vestibular Monitoring in Patients With Cystic Fibrosis
Angela C Garinis1,2,3, Gayla L Poling4, Ronald C Rubenstein5
1National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR.
American Journal of Audiology
|September 22, 2021
Summary
Aminoglycoside antibiotics can cause hearing loss in cystic fibrosis (CF) patients. This study provides recommendations for monitoring ototoxicity, including routine screenings and evaluations, to improve patient outcomes.
Area of Science:
- Otolaryngology
- Pharmacology
- Pulmonology
Background:
- Aminoglycosides are crucial for treating Pseudomonas infections in cystic fibrosis (CF).
- These antibiotics carry a risk of ototoxicity, leading to hearing loss and vestibular dysfunction.
- Current CF care lacks standardized protocols for monitoring aminoglycoside-induced ototoxicity.
Purpose of the Study:
- To develop formalized recommendations for implementing guideline-adherent ototoxicity monitoring in CF patients receiving aminoglycosides.
- To address the clinical need for proactive management of ototoxicity in this vulnerable population.
Main Methods:
- Consensus statement developed by the International Ototoxicity Management Working Group (IOMG).
- Incorporated expert opinion and existing evidence specific to CF patients.
- Utilized national and international guidelines on ototoxicity monitoring.
Main Results:
- Four key recommendations for ototoxicity management in CF patients:
- Integrate hearing, tinnitus, and balance assessments into routine CF history.
- Employ timely point-of-care measures for early detection.
- Establish baseline and post-treatment evaluations for each ototoxic drug course.
- Conduct annual hearing and vestibular evaluations for all patients with prior ototoxic exposure.
Conclusions:
- Implementing a structured ototoxicity management program within the CF care team is essential.
- Improved identification of ototoxicity signs and symptoms facilitates timely interventions.
- Proactive monitoring empowers clinicians and patients to make informed treatment decisions, minimizing adverse events.
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