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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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Ototoxicity among multidrug-resistant TB patients: a systematic review and meta-analysis

I Wrohan1, L Redwood1, J Ho2

  • 1Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Woolcock Institute of Medical Research, Glebe, NSW, Australia.

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|January 1, 2021
PubMed

Insights

Injectable antibiotics for multidrug-resistant tuberculosis (MDR-TB) cause significant hearing loss in nearly 30% of patients. Routine hearing tests are recommended to prevent permanent damage from MDR-TB treatment.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Public Health

Background:

  • Injectable antibiotics are crucial for treating multidrug-resistant tuberculosis (MDR-TB).
  • However, these treatments are linked to significant patient morbidity, primarily long-term hearing loss (ototoxicity).
  • This review assesses the ototoxicity incidence and the role of audiometric monitoring in MDR-TB patients.

Purpose of the Study:

  • To systematically review and evaluate the incidence of ototoxicity in patients undergoing MDR-TB treatment.
  • To examine the evidence supporting routine audiometric monitoring to mitigate hearing loss severity.

Main Methods:

  • A systematic literature search was conducted across six major scientific databases.
  • Meta-analyses were performed to determine the incidence of hearing loss, tinnitus, and vertigo.
  • Hearing loss incidence was stratified by country income and specific injectable agents used.

Main Results:

  • The review included 64 studies with 12,793 patients from 25 countries.
  • Overall, 28.3% of patients on injectable MDR-TB treatment experienced hearing loss, with amikacin showing the highest incidence (33.4%) and capreomycin the lowest (2.0%).
  • Tinnitus and vertigo affected 14.5% and 8.1% of patients, respectively. Audiometry was found to be feasible across various settings.

Conclusions:

  • Injectable antibiotics are a significant cause of morbidity in MDR-TB patients.
  • Routine audiometric monitoring is strongly recommended in settings utilizing these drugs to prevent irreversible hearing damage.

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