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Ototoxic hearing loss from antimalarials: A systematic narrative review
Lauren K Dillard1, Amanda M Fullerton2, Catherine M McMahon2
1Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Communication Sciences & Disorders, University of Wisconsin-Madison, Madison, WI, USA.
Travel Medicine and Infectious Disease
|June 15, 2021
Summary
Antimalarial drugs can cause hearing loss, but evidence on how often this occurs and if it is permanent is limited. Further research is needed to understand antimalarial ototoxicity.
Area of Science:
- Pharmacology
- Ototoxicology
- Public Health
Background:
- Antimalarial treatments carry a risk of ototoxicity, potentially causing irreversible hearing loss.
- Current understanding of the prevalence and permanence of antimalarial-induced hearing loss lacks consensus.
- This review synthesizes existing evidence on the ototoxic effects of antimalarial drugs in humans.
Purpose of the Study:
- To systematically review and synthesize current evidence on the ototoxicity of antimalarial drugs in human populations.
- To identify knowledge gaps regarding the prevalence and permanence of hearing loss associated with antimalarial treatments.
Main Methods:
- Systematic narrative review of studies published between 2005 and 2018.
- Inclusion criteria focused on studies reporting post-treatment hearing loss in individuals treated for malaria.
- Analysis encompassed drug safety, efficacy, and specific ototoxic effects of antimalarials.
Main Results:
- Twenty-two studies from 21 countries were included, with varying focuses on drug safety, efficacy, or ototoxicity.
- Objective hearing data were available from only 9 studies.
- Evidence specifically detailing permanent ototoxic effects of antimalarials remains scarce, with studies examining quinine and artemisinin combination therapies.
Conclusions:
- Antimalarial drugs possess ototoxic potential in certain cases.
- There is a critical need for more research in human populations to characterize the ototoxicity of existing and emerging antimalarials.
- Future randomized trials should prioritize objective measurement and reporting of ototoxic hearing loss as an adverse event.
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