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Sequential analysis as a tool for detection of amikacin ototoxicity in the treatment of multidrug-resistant

Karla Anacleto de Vasconcelos1, Silvana Maria Monte Coelho Frota2, Antonio Ruffino-Netto3

  • 1Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Jornal Brasileiro De Pneumologia : Publicacao Oficial Da Sociedade Brasileira De Pneumologia E Tisilogia
|May 24, 2018
PubMed
Abstract

Insights

High-frequency audiometry (HFA) and pure-tone audiometry (PTA) effectively detect amikacin-induced ototoxicity in multidrug-resistant tuberculosis (MDR-TB) patients. Distortion-product otoacoustic emission (DPOAE) testing was less efficient for early hearing loss detection.

Area of Science:

  • Ototoxicity research
  • Audiology
  • Tuberculosis treatment monitoring

Background:

  • Amikacin is crucial for multidrug-resistant tuberculosis (MDR-TB) treatment.
  • Amikacin can cause ototoxicity, leading to hearing loss.
  • Early detection of hearing damage is vital for patient management.

Purpose of the Study:

  • To evaluate early detection of amikacin-induced ototoxicity.
  • To compare pure-tone audiometry (PTA), high-frequency audiometry (HFA), and distortion-product otoacoustic emission (DPOAE) testing.
  • To assess hearing changes in MDR-TB patients receiving amikacin.

Main Methods:

  • Longitudinal prospective cohort study.
  • Included 18-69 year old MDR-TB patients receiving amikacin for the first time.
  • Hearing assessed at baseline, 2 months, and 6 months using PTA, HFA, and DPOAE.

Main Results:

  • HFA detected hearing shifts at 2 months; PTA detected shifts at 6 months.
  • DPOAE testing did not detect significant hearing threshold shifts.
  • Sequential analysis refined the final study population to 10 patients.

Conclusions:

  • HFA and PTA are effective for detecting amikacin-associated hearing threshold shifts over six months.
  • DPOAE testing demonstrated limited efficiency in identifying early ototoxicity in this cohort.
  • Monitoring hearing with HFA and PTA is recommended during amikacin treatment for MDR-TB.

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