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Macrolide-associated sensorineural hearing loss: A systematic review.

Allison K Ikeda1, Anthony A Prince2, Jenny X Chen2

  • 1School of Medicine, Emory University, Atlanta, Georgia, U.S.A.

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|August 4, 2017
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Summary

Sensorineural hearing loss (SNHL) can occur with macrolide antibiotic use, even at standard doses. While often reversible with drug cessation, some cases may be irreversible, necessitating further research into macrolide ototoxicity.

Keywords:
Sensorineural hearing lossantibiotic adverse effectsmacrolidesototoxicitysystematic review

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Area of Science:

  • Otolaryngology
  • Pharmacology
  • Clinical Medicine

Background:

  • Macrolide antibiotics are widely used for various infections.
  • Sensorineural hearing loss (SNHL) is a potential adverse effect of some medications.
  • The ototoxic potential of macrolides requires further investigation.

Purpose of the Study:

  • To investigate the association between macrolide antibiotics and SNHL.
  • To identify specific macrolide agents and dosages linked to SNHL.
  • To evaluate treatment strategies for reversing macrolide-induced SNHL.

Main Methods:

  • Systematic review of human studies identified through comprehensive literature searches.
  • Inclusion of all study designs and age groups documenting SNHL after macrolide exposure.
  • Extraction of macrolide regimen details, SNHL characteristics, and treatment outcomes.

Main Results:

  • 44 publications reported 78 cases of audiometrically confirmed SNHL associated with macrolides.
  • SNHL occurred with oral and intravenous macrolides at standard and high doses.
  • Most SNHL cases were reversible with macrolide cessation alone or with steroids; however, six cases were irreversible.

Conclusions:

  • Macrolide antibiotic exposure can lead to SNHL, even at standard oral doses.
  • The reversibility of SNHL depends on factors including treatment and drug cessation.
  • Further research is crucial to elucidate the incidence, prevalence, and mechanisms of macrolide ototoxicity.