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Aminoglycosides-Related Ototoxicity: Mechanisms, Risk Factors, and Prevention in Pediatric Patients
Serena Rivetti1, Alberto Romano1, Stefano Mastrangelo1,2
1Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Insights
Aminoglycoside antibiotics can cause permanent hearing loss (ototoxicity) in children. Limiting their use and exploring otoprotective strategies are crucial for preventing this irreversible side effect.
Area of Science:
- Ototoxicology
- Pediatric Pharmacology
- Antibiotic Stewardship
Background:
- Aminoglycosides are vital broad-spectrum antibiotics in pediatric care.
- Aminoglycoside use carries a risk of permanent ototoxicity, affecting inner ear cells.
- Ototoxicity in children can impede neurocognitive and social development.
Purpose of the Study:
- To review the molecular mechanisms of aminoglycoside-induced ototoxicity in pediatric patients.
- To analyze risk factors associated with aminoglycoside ototoxicity.
- To explore potential otoprotective strategies for pediatric patients.
Main Methods:
- Literature review of molecular mechanisms.
- Analysis of risk factors (controllable and uncontrollable).
- Examination of otoprotective interventions.
Main Results:
- Aminoglycosides damage inner ear cells through various molecular pathways.
- Both inherent and modifiable factors contribute to ototoxicity risk.
- Antibiotic stewardship is key to minimizing aminoglycoside exposure.
Conclusions:
- Preventing aminoglycoside ototoxicity is essential due to its permanent nature.
- Understanding molecular mechanisms and risk factors aids in prevention.
- Otoprotective strategies and judicious antibiotic use are vital in pediatric care.
Abstract:
Aminoglycosides are broad-spectrum antibiotics largely used in children, but they have potential toxic side effects, including ototoxicity. Ototoxicity from aminoglycosides is permanent and is a consequence of its action on the inner ear cells via multiple mechanisms. Both uncontrollable risk factors and controllable risk factors are involved in the pathogenesis of aminoglycoside-related ototoxicity and, because of the irreversibility of ototoxicity, an important undertaking for preventing ototoxicity includes antibiotic stewardship to limit the use of aminoglycosides. Aminoglycosides are fundamental in the treatment of numerous infectious conditions at neonatal and pediatric age. In childhood, normal auditory function ensures adequate neurocognitive and social development. Hearing damage from aminoglycosides can therefore strongly affect the normal growth of the child. This review describes the molecular mechanisms of aminoglycoside-related ototoxicity and analyzes the risk factors and the potential otoprotective strategies in pediatric patients.
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