Ototoxic effect of anti-tubercular treatment on multi-drug resistant tuberculosis patient
Keywords:Tuberculosis, Hearing loss, Ototoxicity
Background: Multi-drug resistant tuberculosis (MDR-TB) is defined as tuberculosis caused by Mycobacterium tuberculosis resistant in vitro to the effects of isoniazid and rifampicin, with or without resistance to any other drugs. Regimen for MDR-TB comprises of 6 drugs - kanamycin, levofloxacin, ethionamide, pyrazinamide, ethambutol and cycloserine during 6-9 months of the intensive phase and 4 drugs levofloxacin, ethionamide, ethambutol and cycloserine during the 18 months of the continuation phase. The aim of our study was to document the incidence and severity of ototoxicity in MDR-TB patient receiving category IV treatment under the revised national tuberculosis control program.
Methods: Prospective cohort study was carried out on proven case of MDR-TB patients. Total 61 patients were evaluated for the development of ototoxicity, for a period of one year. First three months of study pre-treatment baseline audiogram were recorded by pure tone audiometry, and repeat audiogram was done after six months and nine months.
Results: Out of 61 patients 21 patients developed ototoxicity with incidence of 34.42%. Incidence of high frequency hearing loss was 21.31% and flat loss was 13.11%.
Conclusions: MDR-TB patients, due to effect of aminoglycoside may develop mild to severe degree of hearing loss. As hearing loss in these patients is permanent, careful audiological monitoring should be done regularly.
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