ABSTRACT
Introduction: People with cystic fibrosis (PwCF) regularly receive antibiotics for treatment of lung infections, which can include intravenous aminoglycosides (IVAG) resulting in potential ototoxicity. Sound booth audiometry is costly, time-consuming, and requires further outpatient visits and audiologists. A quality improvement project delivered by specialist pharmacists to implement a tablet audiometry ototoxicity monitoring programme was launched in PwCF receiving IVAG therapy. Objectives: To implement a tablet ototoxicity screening programme in adults with CF. Methods: PwCF receiving IVAG completed tablet-based audiometry (0.25– 16 kHz) (Shoebox MD) alongside validated ototoxicity questionnaires at the beginning and end of treatment. Following a clinical pathway, clinicians undertook shared decision-making processes regarding continuation of AG if abnormality was detected, alongside referral for sound-booth audiometry. Results: Data were collected from April–Dec 2021. Thirty-eight patients (median [IQR] age 28.5 ([15.5] years;mean [SD] ppFEV1 62.3 [26.5]) were screenedwhowere on IVAG. Fifteen patients (39%)were referred for formal audiometry due to abnormal baseline results, of which 5 had symptoms of hearing loss identified through questionnaires. 3% (1/38) stopped AG therapy due to identified potential ototoxic risk. Twenty-two patients received screening at beginning and end of IVAG therapy: significant ototoxic effects were seen in 2 of these patients (9%);20 patients (91%) had no significant change from baseline audiometry. Conclusions: We present pilot results to show feasibility of tablet-based ototoxicity screening. More IV courses were completed at home than anticipated (due to Covid19) limiting end of IV testing. Further 3-month testing is planned to detect potential delayed ototoxic change. Nevertheless, our results show tablet audiometry to be an effective and practical screening tool used by non-audiologists for accurate, early identification of hearing loss and ototoxicity.