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Sequential analysis as a tool for detection of amikacin ototoxicity in the treatment of multidrug-resistant tuberculosis

Authors :
Karla Anacleto de Vasconcelos
Silvana Maria Monte Coelho Frota
Antonio Ruffino-Netto
Afrânio Lineu Kritski
Source :
Jornal Brasileiro de Pneumologia, Vol 44, Iss 2, Pp 85-92
Publisher :
Sociedade Brasileira de Pneumologia e Tisiologia.

Abstract

ABSTRACT Objective: To investigate early detection of amikacin-induced ototoxicity in a population treated for multidrug-resistant tuberculosis (MDR-TB), by means of three different tests: pure-tone audiometry (PTA); high-frequency audiometry (HFA); and distortion-product otoacoustic emission (DPOAE) testing. Methods: This was a longitudinal prospective cohort study involving patients aged 18-69 years with a diagnosis of MDR-TB who had to receive amikacin for six months as part of their antituberculosis drug regimen for the first time. Hearing was assessed before treatment initiation and at two and six months after treatment initiation. Sequential statistics were used to analyze the results. Results: We included 61 patients, but the final population consisted of 10 patients (7 men and 3 women) because of sequential analysis. Comparison of the test results obtained at two and six months after treatment initiation with those obtained at baseline revealed that HFA at two months and PTA at six months detected hearing threshold shifts consistent with ototoxicity. However, DPOAE testing did not detect such shifts. Conclusions: The statistical method used in this study makes it possible to conclude that, over the six-month period, amikacin-associated hearing threshold shifts were detected by HFA and PTA, and that DPOAE testing was not efficient in detecting such shifts.

Details

Language :
English, Portuguese
ISSN :
18063756
Volume :
44
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Jornal Brasileiro de Pneumologia
Publication Type :
Academic Journal
Accession number :
edsdoj.1eda366a71734103ac09fefbdc58b3af
Document Type :
article
Full Text :
https://doi.org/10.1590/s1806-37562016000000312