Effectiveness of medical interventions implemented during ototoxicity monitoring to prevent further deterioration of hearing thresholds

Hlupheka M. Maluleka, Silva Kuschke, Lebogang Ramma, Smangele Mashele, Matsie M. Ntatamala, Tracy A. Frosler, Ezethu B. Potelwa, Dylan G. Walker


Background: MDR-TB patients are often treated with aminoglycosides which may lead to irreversible ototoxic hearing impairment. Early identification of changes in the hearing thresholds of patient is critical in facilitating treatment modifications that can minimise communication impairment.

Design: A retrospective review of medical records of all patients who underwent ototoxicity monitoring from 2012-2014 was conducted. Patients treated with aminoglycosides and with normal hearing thresholds at baseline were included.

Results: 26 of 509 patient records met inclusion criteria.  There were 9 males and 17 females. The mean age was 36.81±11.48. Half of the participants were on treatment for ≤160 days, whereas the rest were on treatment for ≥161 days. The greatest deterioration in hearing thresholds (post-treatment initiation) occurred in the high frequencies (4-8 kHz). Participants on treatment for >160 days had the greatest deterioration in hearing thresholds. Modifying the frequency of drug administration led to a lesser degree of deterioration of hearing thresholds.

Conclusion: Early detection of deterioration in hearing thresholds can potentially minimise ototoxicity in patients who are being treated with aminoglycosides. More research is needed regarding the effectiveness of these strategies.

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DOI: http://dx.doi.org/10.15641/ur-at-uct.v1i2.38


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