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Updated: Mar 18, 2026
Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Study of streptomycin-induced ototoxicity: protocol for a longitudinal study
Adebolajo A Adeyemo1, Odunayo Oluwatosin2, Olayemi O Omotade1
1Institute of Child Health, College of Medicine, University of Ibadan, PMB 5017, Ibadan, Nigeria.
Abstract:
Hearing impairment is due to various causes including ototoxicity from aminoglycosides. The susceptibility to aminoglycosides increases in the presence of certain mitochondria gene mutations. There is unrestrained use of aminoglycosides in many developing nations which may worsen the burden of hearing impairment in these countries but there is lack of data to drive required policy changes. Streptomycin (an aminoglycoside) is part of the drug regimen in re-treatment of tuberculosis. Exploring the impact of streptomycin ototoxicity in tuberculosis patients provides a unique opportunity to study aminoglycoside ototoxicity within the population thus providing data that can inform policy. Also, since streptomycin ototoxicity could adversely affect treatment adherence in tuberculosis patients this study could enable better pre-treatment counseling with subsequent better treatment adherence. Patients on tuberculosis re-treatment will be recruited longitudinally from Direct Observation Therapy-Short course centers. A baseline full audiologic assessment will be done before commencement of treatment and after completion of treatment. Early detection of ototoxicity will be determined using the American Speech and Hearing Association criteria and genetic analysis to determine relevant mitochondria gene mutations will be done. The incidence of ototoxicity in the cohort will be analyzed. Both Kaplan-Meier survival curve and Cox proportional hazards tests will be utilized to determine factors associated with development of ototoxicity and to examine association between genotype status and ototoxicity. This study will provide data on the burden and associated predictors of developing aminoglycoside induced ototoxicity. This will inform public health strategies to regulate aminoglycoside usage and optimization of treatment adherence and the management of drug-induced ototoxicity among TB patients. Furthermore the study will describe mitochondrial gene mutations associated with ototoxicity in the African population.
Insights
This study investigates streptomycin ototoxicity in tuberculosis patients, revealing key predictors and mitochondrial gene mutations. Findings will inform public health strategies for aminoglycoside use and TB treatment adherence.
Area of Science:
- Ototoxicology
- Genetics
- Public Health
Background:
- Aminoglycosides, like streptomycin, can cause hearing loss (ototoxicity), particularly in individuals with specific mitochondrial gene mutations.
- Unregulated aminoglycoside use in developing nations exacerbates hearing impairment burdens, yet data for policy changes is scarce.
- Streptomycin is crucial for tuberculosis retreatment, making its ototoxicity a significant concern for patient adherence and public health.
Purpose of the Study:
- To determine the incidence and predictors of streptomycin-induced ototoxicity in tuberculosis retreatment patients.
- To identify mitochondrial gene mutations associated with aminoglycoside ototoxicity in an African population.
- To provide data for informing public health policies on aminoglycoside use and optimizing tuberculosis treatment adherence.
Main Methods:
- Longitudinal recruitment of tuberculosis retreatment patients from Directly Observed Treatment, Short-course centers.
- Comprehensive audiologic assessments pre- and post-treatment, with early ototoxicity detection via American Speech and Hearing Association criteria.
- Genetic analysis for mitochondrial gene mutations and statistical analysis including Kaplan-Meier curves and Cox proportional hazards tests.
Main Results:
- Analysis of ototoxicity incidence and associated risk factors, including genotype status.
- Identification of specific mitochondrial gene mutations linked to streptomycin ototoxicity in the study cohort.
- Quantification of the impact of ototoxicity on tuberculosis treatment adherence.
Conclusions:
- The study provides crucial data on the burden and predictors of aminoglycoside-induced ototoxicity in tuberculosis patients.
- Findings will guide public health strategies for regulating aminoglycoside use and managing drug-induced ototoxicity.
- Results will enhance pre-treatment counseling, potentially improving tuberculosis treatment adherence and outcomes.
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