Literature DB >> 28771738

Macrolide-associated sensorineural hearing loss: A systematic review.

Allison K Ikeda1, Anthony A Prince2, Jenny X Chen2, Judith E C Lieu3, Jennifer J Shin2.   

Abstract

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.
© 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Entities:  

Keywords:  Sensorineural hearing loss; antibiotic adverse effects; macrolides; ototoxicity; systematic review

Mesh:

Substances:

Year:  2017        PMID: 28771738     DOI: 10.1002/lary.26799

Source DB:  PubMed          Journal:  Laryngoscope        ISSN: 0023-852X            Impact factor:   3.325


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