Screening and Monitoring of Pharmacotherapy-Induced Ototoxicity in Patients at Dr George Mukhari Academic Hospital - Abstract
Pharmacotherapy-induced ototoxicity is a growing problem as highly effective and
low-cost drugs are prescribed without the necessary monitoring being done. This study
was done to identify and describe medicines with the potential to cause ototoxicity as
part of treatment regimens. This study describes the type of ototoxicity caused and the
prevalence of ototoxicity in this study population. Participants already on treatment
with potential ototoxic medicine and newly initiated participants were referred to
the ototoxicity clinic. Both adult and paediatric patients were included in the study.
Screening of the patients’ current treatment regimen with subsequent identification of
medicines was done prospectively by the pharmacist and the audiological evaluations
were done by audiologists. Fifty-two patients were enrolled in the study, and all of
these patients’ treatment regimens included one or more ototoxic agent. Irreversible
cochleotoxicity in the high and lower frequencies were seen in the majority of patients
treated with aminoglycosides and in patients treated with platinum compounds,
although mostly in the high frequencies. High-frequency hearing loss, both reversible
and irreversible, was also identified in patients treated with loop diuretics. Hearing loss
in the high frequencies occurred in almost two thirds of the study population. This study
highlights the need for a clinical pharmacist, together with an audiologist, functioning
within a multi-disciplinary team, as well as the implementation of ototoxicity monitoring
programs in South Africa.