Aminoglycoside antibiotics are widely used for infections affecting patients of all ages and at different sites, however they carry a risk of ototoxicity, nephrotoxicity and rarely peripheral neuropathy. Preventing ototoxicity is crucial to the maintenance of auditory function and quality of life in patients treated with aminoglycosides. This short article reviews the work on assessment of the cytotoxic properties of apramycin (an aminoglycoside used widely in veterinary medicine), paromomycin (used for protazoal parasitic infections) and sisomicin (a modified biosynthetic precursor of gentamicin) tested on in vitro animal models. Apramycin resulted in significant reduction in threshold shifts and cochlear hair cell loss when compared with gentamicin. Paromomycin and sisomicin both resulted in negligible losses of hair cells. Due to the particular properties of these agents, the article concludes that aminoglycosides that do not bind effectively to eukaryotic ribosomes, or those that are modified with a methysulfonyl group, result in reduced risk of hair cell death and hearing loss. The next steps for research are to evaluate the long-term effects of administration, and identify quantities for correct dosing in the presence of infection.
New aminoglycosides with reduced ototoxicity risk
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