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What are aminoglycoside antibiotics?

Aminoglycoside antibiotics are a group of antibiotics used to treat bacterial infections. In people with cystic fibrosis, aminoglycosides are given to treat lung infections caused by bacteria such as Pseudomonas aeruginosa and Mycobacterium abscessus. Tobramycin and amikacin are examples of aminoglycoside antibiotics which you may be prescribed.

Why have I been prescribed an aminoglycoside?

Your doctor has prescribed an aminoglycoside as it is likely to be the most effective antibiotic to treat the bacteria causing your infection. Sometimes they are the most appropriate choice of antibiotic if you have allergies to other drugs or if the bacteria causing your infection are resistant to other types of antibiotics.

How are aminoglycosides given?

Aminoglycosides are given as part of a two week course of intravenous antibiotics given either in hospital or at home. This can be part of your regular cystic fibrosis care or because you are experiencing an exacerbation of your symptoms.

The drug will be given through an intravenous infusion, and the dose will depend on your age, weight and how well your kidneys are working.

Blood tests are required during the course of treatment to ensure your dose is high enough to kill the bacteria, but not too high to cause side effects. Your dose may be adjusted depending on the results of the blood tests. These tests will be organised by your nursing team.

What are the side effects of aminoglycosides?

All medicines can cause side effects. Common side effects of aminoglycosides are nausea and vomiting, which can be managed by speaking to your cystic fibrosis team.

More serious side effects of aminoglycosides include damage to your kidney and ears.

• Ear damage:
  Ear damage can present as dizziness, balance problems, a ringing in your ears (known as tinnitus) or hearing loss. Please report any of these symptoms to your nursing or medical team. The cystic fibrosis team will organise hearing tests to monitor for any ear damage.
• Kidney damage:
  We will take blood tests to monitor your kidney function during your course of treatment.

The risk of experiencing these side effects increases with longer durations of treatment, higher levels of the drug in your blood and use of some other medications. It is therefore really important you have regular blood tests during your course of treatment and follow your doctor’s advice.

Is there anything I can do?

Please tell us if:

• You have any allergies to medicines
• You are pregnant/ breastfeeding or intending to
• You have any other medical problems, especially:
  • Kidney problems
  • Hearing/balance problems
  • Myasthenia gravis
  • Parkinsons disease
• You are taking any herbal/ homeopathic medicines such as St. Johns Wort
• You experience any side effects

Please attend your routine appointments and your cystic fibrosis team will organise for regular hearing tests.

Will the aminoglycosides interact with my other medication?

Your cystic fibrosis team will look at all of your medication and check whether there will be any interactions with the aminoglycoside antibiotics. It is very important that we are aware of all medication you are taking. This includes herbal medicines and other medicines which you might buy over the counter.

We strongly recommend you DO NOT take non-steroidal anti-inflammatory drugs (NSAID), such as ibuprofen, aspirin or diclofenac (Volterol), when receiving intravenous aminoglycosides. This is because the risk of kidney damage is greater when taking NSAID’s alongside aminoglycosides. If you usually take NSAID’s and/or need some pain relief during your treatment please speak to your nurse, doctor or pharmacist.

Who can I speak to if I have any questions?

Your cystic fibrosis team will be happy to answer any questions you may have about your treatment.

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