rifampin and Deafness

Topics: Algorithms; Animals; Anti-Bacterial Agents; Child; Child, Preschool; Deafness; Dexamethasone; Humans; Infant; Infant, Newborn; Meningitis, Bacterial; Research; Rifampin

The short treatment regimen (STR) achieves a >80% cure in rifampicin-resistant tuberculosis (RR-TB) patients. However, ototoxicity induced by the injectable is a concern. This is the first study to evaluate the replacement of injectables by linezolid in patients with audiometry abnormalities at baseline or during the treatment.We conducted a retrospective cohort study of all RR-TB patients started on the STR between 2016 and June, 2019, in Niger. Patients underwent audiometry every 2 months in 2016 and every month since 2017.Of 195 patients, 16.9% (33 out of 195) received linezolid from the start (n=17), or switched from injectables to linezolid during treatment (n=16), based on audiometry abnormalities. In 2016, two patients developed severe ototoxicity despite switching to linezolid. Since 2017, no patient developed severe hearing loss or complete deafness. Severe haematological toxicity was observed in 18.1% (six out of 33) of patients on linezolid, none of which was life threatening. The use of linezolid was associated with severe but manageable adverse events (hazard ratio 8.9, 95% CI 2.5-31.5; p=0.001). A total of 90.9% (30 out of 33) of patients on a linezolid-containing STR were cured, and none experienced treatment failure. Three died, but not due to adverse events.Baseline and monthly audiometry monitoring and using linezolid after detection of hearing abnormalities appears effective to prevent severe ototoxicity, while keeping high treatment success and manageable adverse events.

Topics: Antitubercular Agents; Deafness; Hearing Loss; Humans; Linezolid; Ototoxicity; Retrospective Studies; Rifampin; Treatment Outcome; Tuberculosis, Multidrug-Resistant

The evolution of threshold values of air conduction in the extended high frequency range (9-18 kHz) at patients suffering from the active pulmonary tuberculosis treated with the combined therapy (SM, INH, RFM, PZA). There were audiologically examined 13 patients (the average age 41.2) suffering from the active pulmonary tuberculosis and treated with the combined therapy (SM, INH, RFM, PZA). In 13 tuberculosis patients the full range of audiometric tests and measurements including: the pure tone audiometry, acoustic impedance and the extended high frequency range threshold audiometry (9-18 kHz) have been applied before starting the treatment with SM, INH, RMP and PZA and in the two months later--after its completion. The reference group was composed of 10 audiologically healthy individuals (the average age 40.2). A significant hearing loss with respect to air conduction within the extended range of high frequencies (9-17 kHz) was stated. The said hearing pathology can be diagnosed at earlier stages by the use of the extended high frequency range audiometry than through applying methods of conventional audiometry.

Topics: Adult; Antitubercular Agents; Audiometry, Pure-Tone; Auditory Threshold; Case-Control Studies; Deafness; Dose-Response Relationship, Drug; Humans; Isoniazid; Male; Middle Aged; Poland; Pyrazinamide; Rifampin; Streptomycin; Tuberculosis, Pulmonary

A 20-year-old male Turkish immigrant to Norway suffering from severe chronic neurobrucellosis with spastic paraplegia and deafness is presented. The diagnosis was established by isolation of Brucella melitensis from cerebrospinal fluid (CSF) culture. Brucella antibody agglutination titers were high in serum and CSF. In spite of intensive, prolonged treatment with a combination of trimethoprim-sulfamethoxazole (TPM-SMZ), rifampicin and doxycycline, the course of the illness was characterized by relapses and severe neurological defects.

Topics: Adult; Agglutination; Brucellosis; Deafness; Humans; Male; Paraplegia; Rifampin; Trimethoprim, Sulfamethoxazole Drug Combination; Turkey

Topics: Aminosalicylic Acids; Animals; Antitubercular Agents; Capreomycin; Chemical and Drug Induced Liver Injury; Cycloserine; Deafness; Drug Hypersensitivity; Ethambutol; Ethionamide; Gastrointestinal Diseases; Goiter; Humans; Isoniazid; Kanamycin; Liver; Mental Disorders; Mice; Nervous System Diseases; Pyrazinamide; Rifampin; Streptomycin; Thioacetazone; Tuberculosis; Viomycin