195 The effect of aminoglycoside antibiotics therapy on audiovestibular function in cystic fibrosis patients at the All Wales Adult Cystic Fibrosis Centre (AWACFC)

Abstract

Aims 1.To determine the prevalence and severity of audiovestibular (AV) disease in adult CF patients attending the AWACFC. 2.To examine any potential link between AV disease and number of days of IV aminoglycosides (AG) received and duration of nebulised AG. Method The annual reviews of patients attending the AWACFC between 2009 and 2014 were reviewed retrospectively. Patients who had reported AV symptoms and received an assessment at an AV clinic were included and their cumulative number of days of IV AG and the length of time receiving nebulised AG was collected. Results 30 (12 male) of the 254 (12%), with a mean (SD) age of 34.2 (8.9) years, had described AV symptoms and been seen in AV clinic. 19 of the 30 patients were found to have some sensorineural (SN) hearing loss. Patients with SN hearing loss had a greater mean number of days on IV AG (340 days) than those with measured normal hearing (247 days) but the least days nebulised AG. 7 patients had vestibular dysfunction (VD). Patients with VD had a greater mean number of days on IV AG than those with normal vestibular function (386 vs 152 days). Conclusion The prevalence of SN hearing loss in AWACFC is less than previous reports (CF Trust 2009) perhaps due to underreporting of symptoms. SN hearing loss and VD were associated with greater number of days on IV AG which concurs with previous studies (Mulheran 2001). The greater the number of days on nebulised AG conferred less hearing damage. This may be explained by nebulised AG being withheld during course of IV AG or by greater long term nebulised AG usage resulting in reduced need for more toxic IV courses of AG. However, patient adherence was not assessed.