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Updated: Feb 25, 2026
Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
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.
Objectives:
To investigate the potential association of macrolide antibiotics with sensorineural hearing loss (SNHL) and which agents and dosage may be related. To evaluate whether an optimal treatment exists for reversing SNHL that occurs after macrolide therapy.
Study Design:
Systematic review of the literature.
Methods:
Computerized (PubMed, EMBASE, Cochrane Library) and manual searches were performed to identify human studies of all ages (patients) who received macrolides (intervention, with or without control) and documented SNHL (outcome). All study designs were assessed. Extracted data included macrolide regimen details, as well as the timing, severity, and reversibility of SNHL with drug cessation alone or with additional medical intervention. Study designs and the associated risk of bias were assessed.
Results:
The 44 publications (3 prospective, 41 retrospective) that met these criteria described 78 cases of audiometrically confirmed SNHL. SNHL was associated with oral and intravenous macrolide administration at standard and elevated doses. SNHL was irreversible in six cases, despite macrolide cessation (n = 5) and oral steroid treatment (n = 1). Irreversible SNHL was observed following 2 to 3 days of exposure. SNHL was reversible with macrolide cessation alone in 70 cases. In two cases, macrolide cessation coupled with oral steroid administration restored hearing. Reversible cases improved within hours to days. Nine studies also described 42 cases of subjective patient-reported hearing loss. Limitations in the data arose from study design, related comorbidities, and concomitant drug administration.
Conclusion:
SNHL may follow macrolide exposure, even at standard oral doses. Further research is needed to understand the incidence, prevalence, and biological mechanism of its ototoxicity. Laryngoscope, 128:228-236, 2018.
Insights
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.
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.
