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Erythromycin ototoxicity: a call to heighten recognition.
C J Whitener1, J E Parker, N L Lapp
1Department of Medicine, Milton S. Hershey Medical Center, Hershey, Pa.
Southern Medical Journal
|October 1, 1991
Summary
High-dose erythromycin treatment can cause temporary bilateral sensorineural hearing loss. This reversible ototoxicity may be linked to patient factors like age and organ function.
Area of Science:
- Pharmacology
- Ototoxicology
- Infectious Diseases
Background:
- Bacteremic pneumococcal pneumonia requires effective antibiotic treatment.
- Erythromycin lactobionate is used for severe bacterial infections.
- Ototoxicity is a potential adverse effect of certain medications.
Observation:
- A 64-year-old woman developed bilateral sensorineural hearing loss during treatment for bacteremic pneumococcal pneumonia.
- The patient was receiving intravenous erythromycin lactobionate for her infection.
- The hearing impairment resolved rapidly after the erythromycin treatment was stopped.
Findings:
- High-dose erythromycin therapy was associated with reversible ototoxicity in this patient.
- The hearing loss was sensorineural, affecting both ears.
- Discontinuation of erythromycin lactobionate led to a prompt recovery of hearing function.
Implications:
- Erythromycin ototoxicity, while infrequent, should be considered as a potential adverse effect, especially with high doses.
- Factors such as patient age, gender, and hepatic/renal function may influence susceptibility to erythromycin-induced hearing loss.
- Clinicians should be vigilant for auditory changes in patients receiving high-dose erythromycin and consider ototoxicity in the differential diagnosis of hearing deficits.