Aminoglycosides Use

Aminoglycoside antibiotics (AGs) are some of the earliest and most effective antibiotics. They continue to be used worldwide to treat a variety of life threatening bacterial infections including: pulmonary infections in patients with cystic fibrosis, non-tuberculous mycobacterial (NTM) lung disease, complicated urinary tract infections, endocarditis, neonatal septicemia, pseudomonas respiratory infections, and multiple drug resistant tuberculosis. With that efficacy, however, comes the risk of permanent hearing loss and balance problems, which can have a significant impact on quality of life. All aminoglycoside antibiotics carry boxed warnings regarding the potential for loss of hearing and balance, and multiple studies have reported the incidence of measurable hearing loss in patients undergoing short courses of AG therapy (< 3 weeks) at up to 20%.  Hearing loss is even more common in long duration therapy.  It is reported that as many as 35% of NTM patients, treated for up to three months with amikacin, have inner-ear issues, some requiring cessation of therapy.  Among those patients who require repeat courses of aminoglycosides over their life, such as people with cystic fibrosis, it has been reported that that between ~25%  and ~80% of individuals experience hearing loss.

Despite this limitation, based on data provided by IMS Health, there are still more than 500 million patient-days of parenteral AGs given worldwide each year.

The availability of an adjunct therapy to protect against the ototoxic side effect of AGs would allow AGs to be used worldwide in more cases as a first-line therapy and to treat additional infections where currently they are avoided.