Progress of ototoxicity induced by amikacin in the treatment of multidrug-resistant tuberculosis

Abstract

Amikacin has good antimicrobial activity against Mycobacterium tuberculosis and gram-negative bacilli. Because of its definite curative effect and low price, amikacin plays an important role in the treatment of multidrug-resistant tuberculosis (MDR-TB). Although amikacin is classified as group C drug in the WHO guidelines for the treatment of MDR-TB in 2018, amikacin may still be used to treat MDR-TB in China due to the difficulties in obtaining bedaquiline and linezolid and the high rate of fluoroquinolone resistance in China. Amikacin should be used for at least 6 months in the treatment of MDR- TB. The incidence of ototoxicity caused by long-term use of amikacin is high. Severe tinnitus and hearing loss not only bring pain to patients, but also may lead to interruption of treatment. In this paper, we summarized the research progress on the occurrence, mechanism, risk factors and prevention of amikacin-induced ototoxicity at home and abroad in recent years, so as to provide help for clinical treatment of amikacin-induced ototoxicity.

Abstract

摘要： 阿米卡星(又称“丁胺卡那霉素”)对结核分枝杆菌及革兰阴性杆菌均有良好的抗菌活性。因疗效明确、价格 低廉, 其在耐多药结核病的治疗中占据重要地位, 虽然 2018 年 WHO 耐药结核病治疗指南中将阿米卡星归人C组药物, 但鉴于我国贝达喹啉、利奈唑胺获取困难及喹诺酮耐药率高, 阿米卡星可能仍将是我国治疗耐多药结核病的重要药 物。在耐多药结核病治疗中需使用至少 6 个月阿米卡星, 长疗程使用阿米卡星引起的耳毒性发生率高, 严重的耳鸣和 听力减退不仅为患者带来了痛苦, 而且还可能导致治疗的中断。本文通过总结近年来国内外对阿米卡星引起耳毒性 的发生情况、机制、危险因素、预防的研究进展, 为临床应对阿米卡星引起的耳毒性提供帮助。