Aminoglycosides: old friend... new foe?

Over a relatively short period, cystic fibrosis (CF) has gone from a disease of dying children to one where survival well into adulthood is expected. It was recently reported that by 2025, the adult CF population in Western Europe would increase by 75% [1]. Although the reasons for improved survival are complex, one contributor is the aggressive use of antibiotics including aminoglycosides. However, aminoglycosides have well-recognised adverse effects, particularly nephrotoxicity and ototoxicity. Clear relationships between these effects and aminoglycoside concentrations or exposure have yet to be defined.