Ototoxic Reaction to Erythromycin

Agustı́, Carles; F, Ferran; Gea, Joaquim; Picado, César

doi:10.1001/archinte.1991.00400020124025

Cited by 19 publications

(5 citation statements)

References 4 publications

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“…Permanent vestibular damage has been reported after intravenous erythromycin lactobionate in a patient with normal liver and kidney function despite having blood levels in the normal range. The patient also had SNHL that recovered after discontinuing erythromycin, but vestibular dysfunction persisted (36).…”

Section: Erythromycin Ototoxicity Clinical Studiesmentioning

confidence: 95%

Ototoxicity of Non-aminoglycoside Antibiotics

2021

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It is well-known that aminoglycoside antibiotics can cause significant hearing loss and vestibular deficits that have been described in animal studies and in clinical reports. The purpose of this review is to summarize relevant preclinical and clinical publications that discuss the ototoxicity of non-aminoglycoside antibiotics. The major classes of antibiotics other than aminoglycosides that have been associated with hearing loss in animal studies and in patients are discussed in this report. These antibiotics include: capreomycin, a polypeptide antibiotic that has been used to treat patients with drug-resistant tuberculosis, particularly in developing nations; the macrolides, including erythromycin, azithromycin and clarithromycin; and vancomycin. These antibiotics have been associated with ototoxicity, particularly in neonates. It is critical to be aware of the ototoxic potential of these antibiotics since so much attention has been given to the ototoxicity of aminoglycoside antibiotics in the literature.

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Section: Erythromycin Ototoxicity Clinical Studiesmentioning

confidence: 95%

Ototoxicity of Non-aminoglycoside Antibiotics

2021

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“…The standard intravenous dose exposure of 4 grams per day was given in 16 studies (n 5 32 cases). 14,15,24,[35][36][37][38][39][40][41][42][43][44][45][46][47] A higher dose exposure of 6 grams per day was described in two patients. 48,49 Six studies included patients who received less than 4 grams per day.…”

Section: Macrolide Dosing and Administrationmentioning

confidence: 99%

“…In 27 reversible cases, SNHL was sudden and bilateral (Appendix 3; available online). 24,29,30,34,35,[38][39][40][41][42][43][46][47][48][49][51][52][53][54][55][56][57][58][59][60][61] High-frequency hearing loss was specifically reported in eight studies (n 5 12 patients). 24,33,38,42,46,51,55,61 SNHL at all frequencies was specified in seven studies (n 5 12 patients).…”

Section: Irreversibility/reversibility Of Sensorineural Hearing Lossmentioning

confidence: 99%

“…63 Recovery times, however, were as long as 4 months. 52 For intravenous erythromycin, subjectively hearing improvements were reported at 12 hours postcessation 40 and complete reversal as early as 72 hours 42 ; the longest time to improvement was in a case followed for 21 days due to continued use of lower dose erythromycin. 36 Reversible With Cessation of Macrolide and Steroid Intervention.…”

Section: Irreversibility/reversibility Of Sensorineural Hearing Lossmentioning

confidence: 99%

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Macrolide‐associated sensorineural hearing loss: A systematic review

et al. 2017

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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 5) and oral steroid treatment (n 5 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.

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“…3,7,11 However, irreversible ototoxicity has also been reported due to ER. [15][16][17] Typically, hearing loss due to macrolides is bilateral, symmetrical, sensorineural type at speech frequencies rather than high frequencies. 3,[7][8][9] With the latest techniques, evoked otoacoustic emissions can be used to detect initial signs of cochlear injury due to ototoxic drugs.…”

Section: Introductionmentioning

confidence: 99%

Reversible ototoxic effect of azithromycin and clarithromycin on transiently evoked otoacoustic emissions in guinea pigs

et al. 2001

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The possible cochlear toxicity of systemically applied macrolides--erythromycin (ER), azithromycin (AZ) and clarithromycin(CL)--was investigated in guinea pigs by measuring transiently evoked otoacoustic emissions (TEOAEs). A single dose of 125 mg/kg intravenous (i.v.) ER caused no change in TEOAEs in guinea pigs (p>0.05), whereas AZ (45 mg/kg orally) and CL (75 mg/kg i.v.) reversibly reduced the emission response (p<0.05). The reversible reduction of TEOAE responses due to AZ and CL, which is in accordance with the clinical picture of AZ and CL ototoxicity, could likely be attributable to the transient dysfunction of outer hair cells. The present study reveals that at least one ototoxic effect of AZ and CL is on the inner ear. The results may also encourage planning clinical researches on TEOAE monitoring in patients receiving high doses of AZ or CL.

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Ototoxic Reaction to Erythromycin

Cited by 19 publications

References 4 publications

Ototoxicity of Non-aminoglycoside Antibiotics

Ototoxicity of Non-aminoglycoside Antibiotics

Macrolide‐associated sensorineural hearing loss: A systematic review

Reversible ototoxic effect of azithromycin and clarithromycin on transiently evoked otoacoustic emissions in guinea pigs

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