Irreversible sensorineural hearing loss due to clarithromycin

Area of Science:

• Otolaryngology
• Pharmacology

Background:

• Clarithromycin, an advanced macrolide antibiotic, is frequently prescribed for respiratory infections.
• Reversible sensorineural deafness has been documented as a rare side effect of macrolides, often dose-dependent.
• The proposed mechanism involves transient outer hair cell dysfunction.

Observation:

• An 81-year-old woman developed right-sided sensorineural deafness.
• The onset occurred shortly after initiating low-dose oral clarithromycin for chronic obstructive pulmonary disease exacerbation.
• Hearing loss persisted despite drug cessation after only three days.

Findings:

• The patient experienced irreversible sensorineural deafness.
• This outcome contrasts with previously reported reversible cases.
• The association with low-dose, short-term clarithromycin use is a novel observation.

Implications:

• This case suggests that irreversible hearing loss may be a potential adverse effect of clarithromycin, even at low doses and short durations.
• Further investigation into the ototoxic potential of clarithromycin is warranted.
• Clinicians should be aware of this rare but severe potential side effect in patients, particularly the elderly.