Lower ototoxicity and absence of hidden hearing loss point to gentamicin C1a and apramycin as promising antibiotics for clinical use

Sci Rep. 2019 Feb 20;9(1):2410. doi: 10.1038/s41598-019-38634-3.

Abstract

Spread of antimicrobial resistance and shortage of novel antibiotics have led to an urgent need for new antibacterials. Although aminoglycoside antibiotics (AGs) are very potent anti-infectives, their use is largely restricted due to serious side-effects, mainly nephrotoxicity and ototoxicity. We evaluated the ototoxicity of various AGs selected from a larger set of AGs on the basis of their strong antibacterial activities against multidrug-resistant clinical isolates of the ESKAPE panel: gentamicin, gentamicin C1a, apramycin, paromomycin and neomycin. Following local round window application, dose-dependent effects of AGs on outer hair cell survival and compound action potentials showed gentamicin C1a and apramycin as the least toxic. Strikingly, although no changes were observed in compound action potential thresholds and outer hair cell survival following treatment with low concentrations of neomycin, gentamicin and paromomycin, the number of inner hair cell synaptic ribbons and the compound action potential amplitudes were reduced. This indication of hidden hearing loss was not observed with gentamicin C1a or apramycin at such concentrations. These findings identify the inner hair cells as the most vulnerable element to AG treatment, indicating that gentamicin C1a and apramycin are promising bases for the development of clinically useful antibiotics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aminoglycosides / adverse effects
  • Aminoglycosides / pharmacology
  • Animals
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / pharmacology
  • Cell Line
  • Drug Resistance, Bacterial / drug effects
  • Drug Resistance, Bacterial / genetics
  • Gentamicins / adverse effects
  • Gentamicins / pharmacology*
  • Gentamicins / therapeutic use
  • Guinea Pigs
  • Hair Cells, Auditory, Inner / drug effects
  • Hair Cells, Auditory, Inner / pathology
  • Hearing Loss / chemically induced
  • Hearing Loss / genetics*
  • Hearing Loss / pathology
  • Humans
  • Nebramycin / adverse effects
  • Nebramycin / analogs & derivatives*
  • Nebramycin / pharmacology
  • Neomycin / adverse effects
  • Neomycin / pharmacology
  • Ototoxicity / metabolism*
  • Ototoxicity / pathology
  • Protein Synthesis Inhibitors / adverse effects
  • Protein Synthesis Inhibitors / pharmacology
  • Round Window, Ear / drug effects
  • Round Window, Ear / pathology

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Gentamicins
  • Protein Synthesis Inhibitors
  • Nebramycin
  • gentamicin C
  • apramycin
  • Neomycin