Sacristán J A, Soto J A, de Cos M A
Hospital Marqués de Valdecilla, Santander, Spain.
Ann Pharmacother. 1993 Jul-Aug;27(7-8):950-5. doi: 10.1177/106002809302700724.
To report 11 cases of possible erythromycin-induced hearing loss and to review all cases reported in the literature.
In the 11 cases reported, the following are reviewed: age, gender, time to onset of and recovery from hypoacusis in relation to erythromycin administration, presence or absence of renal or hepatic disease, underlying disorders, and concurrent administration of other drugs. Hypoacusis appeared with dosages equal to or higher than 4 g/d in patients with a mean age of 52.5 +/- 19 years, a high percentage of whom (45 percent) presented with renal impairment. The hearing loss was reversible in all cases, and subsided a few days (median = 3) after dosage reduction or drug discontinuation.
Our patients' characteristics are similar to those of patients reported in the literature. Most data indicate that erythromycin-induced hypoacusis is a dose-dependent effect; however, its occurrence in patients otherwise free from disposing factors suggests that it is idiosyncratic.
Erythromycin administered for appropriate indications and dosage adjustments in patients with impaired renal and/or liver function may prevent or reduce the incidence of erythromycin-induced hypoacusis.
报告11例可能由红霉素引起的听力损失病例，并回顾文献中报道的所有病例。
在所报告的11例病例中，对以下内容进行了回顾：年龄、性别、与红霉素给药相关的听力减退的发作时间和恢复时间、是否存在肾脏或肝脏疾病、基础疾病以及是否同时使用其他药物。平均年龄为52.5±19岁的患者在剂量等于或高于4 g/d时出现听力减退，其中很大一部分患者（45%）存在肾功能损害。所有病例的听力损失都是可逆的，在剂量减少或停药后几天（中位数=3天）听力减退症状消退。
我们患者的特征与文献中报道的患者相似。大多数数据表明，红霉素引起的听力减退是一种剂量依赖性效应；然而，在没有其他易患因素的患者中出现这种情况表明这是一种特异质性反应。
对肾功能和/或肝功能受损的患者，根据适当的适应证给药并调整剂量，可能预防或减少红霉素引起的听力减退的发生率。
