Sensorineural Hearing Loss as a Probable Serious Adverse Drug Reaction Associated with Low-Dose Oral Azithromycin

BACKGROUND: Hearing loss as a possible side effect of azithromycin has been recognized since 1994. Most reports suggesting a link between sensorineural hearing loss (SNHL) and this drug have been in association with prolonged doses for treatment of Mycobacterium lung disease. Mild-moderate, gradual, and reversible SNHL in the speech frequencies has been most often reported. MATERIALS AND METHODS: We describe irreversible SNHL in a patient in association with low-dose oral azithromycin prescribed for acute otitis media. We summarize the available evidence, including a systematic literature review, in support of a possible causal association between SNHL and low-dose azithromycin therapy. INTERPRETATION/DISCUSSION: Physicians should be aware of the potential for even low-dose, oral azithromycin to cause irreversible SNHL as a serious adverse drug reaction in some patients.