Cystic fibrosis, aminoglycoside treatment and acute renal failure: the not so gentle micin

Pediatr Nephrol. 2009 May;24(5):925-8. doi: 10.1007/s00467-008-1036-2. Epub 2008 Nov 13.


Aminoglycosides have a wide spectrum of gram-negative anti-bacterial activities and are available at low cost, which makes them commonly used drugs, especially for patients with cystic fibrosis (CF), who often suffer from chronic lung infections from Pseudomonas aeruginosa. Unfortunately, this treatment seems to have resulted in an increased incidence of acute renal failure (ARF) in patients with CF. A recent case-control study investigated risk factors for ARF in CF patients and suggested intravenous use of gentamicin as the prime culprit. Moreover, in most cases, at least one other risk factor, such as CF-related diabetes, pre-existing renal failure, dehydration or concurrent use of other nephrotoxic drugs, was present. We comment on the renal handling of aminoglycosides and the possible mechanisms of toxicity, as well as strategies for risk minimisation.

Publication types

  • Editorial

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / prevention & control
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / metabolism
  • Contraindications
  • Cystic Fibrosis / complications*
  • Gentamicins / adverse effects*
  • Gentamicins / metabolism
  • Humans
  • Injections, Intravenous
  • Kidney / drug effects
  • Kidney / metabolism
  • Pseudomonas Infections / drug therapy*
  • Risk Factors


  • Anti-Bacterial Agents
  • Gentamicins