Second-line injectable

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Putra, O., N.H., A., Hidayat, F., & Sagitha, I. (2022). OTOTOXICITY IN MULTIDRUG-RESISTANT TUBERCULOSIS: A SCOPING REVIEW OF THE INDONESIAN STUDIES. Journal of Pharmaceutical And Sciences, 5(1), 62-73. https://doi.org/10.36490/journal-jps.com.v5i1.71
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A wide variation in ototoxicity or hearing loss due to injectable anti-tubercular drugs in patients with multidrug-resistant tuberculosis (MDR-TB) has been reported globally and in Indonesia. This scoping review assesses the ototoxicity of second-line injectable anti-tubercular drugs in Indonesian patients with MDR-TB. This review was conducted under the recommended PRISMA extension for scoping review (PRISMA-ScR). The Google Scholar and PubMed database were used to search the articles on MDR-TB in the Indonesian population. Seven studies were identified based on the inclusion criteria reporting kanamycin and capreomycin in the management of MDR-TB. Ototoxicity was observed in 39.3% (116/295) MDR-TB patients. Ototoxicity was observed in kanamycin, 38.7% (105/271 patients); capreomycin, 36,8% (7/19 patients); and kanamycin plus capreomycin, 80% (4/5 patients).  Only one study reported risk factors ototoxicity in MDR-TB patients. Ototoxicity was significantly associated with older age and the length of kanamycin therapy correlates with hearing loss. This review identified a high prevalence of ototoxicity in Indonesian patients with MDR-TB treated with second-line injectable drugs. Efforts were urgently needed to develop guidelines for monitoring ototoxicity, improving pharmacist and clinician awareness, and educating patients or caregivers to report hearing loss symptoms as a sign of ototoxicity.


Keywords: MDR-TB; Ototoxicity, Second-line injectable





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