Feldman L, Efrati S, Eviatar E, Abramsohn R, Yarovoy I, Gersch E, Averbukh Z, Weissgarten J
Nephrology Division, Assaf Harofeh Medical Center, Zerifin, Israel.
Kidney Int. 2007 Aug;72(3):359-63. doi: 10.1038/sj.ki.5002295. Epub 2007 Apr 25.
Aminoglycoside (AG) antibiotics are associated with several side effects, including a reversible nephrotoxicity and a permanent ototoxicity. Oxidative stress is thought to contribute to the pathophysiology of both conditions. We studied the possible protective effect of the antioxidant N-acetylcysteine (NAC) in gentamicin-induced hearing loss in hemodialysis patients. This study includes 53 hemodialysis patients scheduled to receive gentamicin for dialysis catheter-related bacteremia that were randomized to receive the antibiotic with or without NAC. Hearing function was assessed by the standard technique of pure-tone audiograms over a range of frequencies. Audiometric evaluations were performed at baseline, 1 week and at 6 weeks after the completion of gentamicin therapy. A total of 40 patients completed the study protocol with a mean duration of therapy of almost 15 days. At both 1 and 6 weeks after the completion of antibiotic therapy, there were significantly more patients exhibiting ototoxicity in the control group compared with the group receiving NAC. Additionally, significantly more patients in the control group had bilateral ototoxicity. The greatest otoprotective effect of NAC was noticed in the high audiometric tone frequencies. Taken together, our study suggests that NAC treatment may ameliorate gentamicin-induced ototoxicity in hemodialysis patients.
氨基糖苷类（AG）抗生素会引发多种副作用，包括可逆性肾毒性和永久性耳毒性。氧化应激被认为在这两种情况的病理生理过程中起作用。我们研究了抗氧化剂N-乙酰半胱氨酸（NAC）对血液透析患者庆大霉素所致听力损失的可能保护作用。本研究纳入了53例因透析导管相关菌血症而计划接受庆大霉素治疗的血液透析患者，这些患者被随机分为两组，一组接受抗生素治疗时加用NAC，另一组不加用NAC。通过纯音听力图的标准技术在一系列频率范围内评估听力功能。在基线、庆大霉素治疗结束后1周和6周进行听力测定评估。共有40例患者完成了研究方案，平均治疗时长约15天。在抗生素治疗结束后的1周和6周，与接受NAC的组相比，对照组中出现耳毒性的患者明显更多。此外，对照组中双侧耳毒性的患者明显更多。在高听力测定音调频率中观察到NAC的最大耳保护作用。综上所述，我们的研究表明NAC治疗可能改善血液透析患者庆大霉素所致的耳毒性。
