Pediatric Pearl

Sensorineural Hearing Loss in Pediatric, Young Adult Patients Associated With Macrolide Use

06/10/2023

  • The Research

    The authors of a case-control study examined 875 patients from neonates to 18 years of age with diagnosed sensorineural hearing loss (SNHL) and matched them with 875 control patients. They then examined for antibiotic exposure within the last year and compared the odds of having received a macrolide prescription with the odds of having received a penicillin prescription.

    The Results

    Consistent with earlier reports of SNHL in adults, the authors found that the adjusted odds ratio for a child with SNHL had a macrolide prescription within the last year compared with a penicillin prescription was 1.31 (95% CI, 1.05 to 1.64). This finding suggests that children with SNHL had increased odds of outpatient oral macrolide use compared with penicillin use. The authors found that this was particularly the case when the child received a diagnosis more than 180 days after exposure (adjusted odds ratio, 1.79; 95% CI, 1.23 to 2.60). Still, the authors concluded that further study of the association between macrolide antibiotics and SNHL is needed.

    The Bottom Line

    The data here are not overwhelming. Nonetheless, when combined with the significant risks of allergic reactions, arrhythmias, gastrointestinal adverse effects, and drug interactions, the present study adds to my reluctance to use macrolide antibiotics in children unless no other antibiotic is appropriate.

     

    Reference:

    Dabekaussen KFAA, Andriotti T, Ye J, Prince AA, et al. Association of outpatient oral macrolide use with sensorineural hearing loss in children, adolescents, and young adults. JAMA Otolaryngol Head Neck Surg. 2022:e221293. doi:10.1001/jamaoto.2022.1293