Abstract
BackgroundMulti-drug resistant tuberculosis has emerged as a significant problem with the resurfacing of tuberculosis and thus the need to use the second line drugs with the resultant increased incidence of adverse effects. We discuss the effect of second line aminoglycoside anti-tubercular drugs on the hearing status of MDR-TB patients.MethodsSixty four patients were put on second line aminoglycoside anti-TB drugs. These were divided into three groups: group I, 34 patients using amikacin, group II, 26 patients using kanamycin and group III, 4 patients using capreomycin.ResultsOf these, 18.75% of the patients developed sensorineural hearing loss involving higher frequencies while 6.25% had involvement of speech frequencies also. All patients were seen again approximately one year after aminoglycoside discontinuation and all hearing losses were permanent with no threshold improvement.ConclusionAminoglycosides used in MDR-TB patients may result in irreversible hearing loss involving higher frequencies and can become a hearing handicap as speech frequencies are also involved in some of the patients thus underlining the need for regular audiologic evaluation in patients of MDR-TB during the treatment.
Highlights
Multi-drug resistant tuberculosis has emerged as a significant problem with the resurfacing of tuberculosis and the need to use the second line drugs with the resultant increased incidence of adverse effects
Adherence to treatment is a critical factor in the management of MDR-TB and adverse events associated with second line drugs could have a severe impact on adherence because long term use of second line drugs is required in MDR-TB ranging from 18–24 months [21]
The present study evaluates the effect of parenteral second line aminoglycosides namely amikacin, kanamycin and capreomycin on hearing status of MDR-TB patients
Summary
Multi-drug resistant tuberculosis has emerged as a significant problem with the resurfacing of tuberculosis and the need to use the second line drugs with the resultant increased incidence of adverse effects. We discuss the effect of second line aminoglycoside antitubercular drugs on the hearing status of MDR-TB patients. Emergence of resistance to drugs used to treat tuberculosis and multi-drug resistant (MDR-TB) has become an obstacle to effective global TB control [2]. Inappropriate treatment results in unacceptably low cure rates and the continued spread of tuberculosis in the community because of selection of M. tuberculosis isolates that are resistant to anti- tubercular drugs [4]. Most of the problems from which drug-resistance originates are related to the length of treatment (especially considering tolerability and adherence), the longer time that is required to treat MDR-TB results in an additional risk of poor treatment (page number not for citation purposes)
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