Background

Drugs used in curative and prophylactic antimalarial treatment may be ototoxic and lead to permanent hearing loss, but there is no consensus regarding prevalence and permanence of ototoxic hearing loss caused by antimalarials. The purpose of this systematic narrative review was to synthesize current evidence on antimalarial ototoxicity in human populations.

Method

Studies published between 2005 and 2018 that reported prevalence of post-treatment hearing loss in individuals treated for malaria were included.

Results

Twenty-two studies including data from 21 countries were included. Primary themes of the included studies were to evaluate drug safety and/or efficacy (n = 13) or ototoxic effects of drugs (n = 9). Hearing data were measured objectively in 9 studies. Five studies focused on quinine (or derivates), 10 focused on artemisinin combination therapies, and 7 considered multiple drug combinations. There is a paucity of evidence that thoroughly reports potentially permanent ototoxic effects of antimalarials.

Conclusions

Antimalarial drugs may be ototoxic in some cases. More research in human populations is needed to describe ototoxicity of current antimalarials and of future drugs that will be used/developed in response to antimalarial resistance. It is recommended that randomized trials evaluating drug safety objectively measure and report ototoxic hearing loss as an adverse event.

中文翻译：

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抗疟药引起的耳毒性听力损失：系统叙述

背景

用于治疗性和预防性抗疟治疗的药物可能具有耳毒性并导致永久性听力损失，但关于抗疟药引起的耳毒性听力损失的流行率和持久性尚未达成共识。本系统叙述性综述的目的是综合目前关于人类抗疟耳毒性的证据。

方法

2005 年至 2018 年间发表的研究报告了接受疟疾治疗的个体治疗后听力损失的患病率。

结果

包括来自 21 个国家的数据的 22 项研究被纳入。纳入研究的主要主题是评估药物安全性和/或有效性（n = 13）或药物的耳毒性作用（n = 9）。在 9 项研究中客观地测量了听力数据。5 项研究侧重于奎宁（或衍生物），10 项研究侧重于青蒿素联合疗法，7 项研究考虑了多种药物组合。很少有证据能够彻底报告抗疟药的潜在永久性耳毒性作用。

结论

在某些情况下，抗疟药可能具有耳毒性。需要对人群进行更多研究，以描述当前抗疟药和未来将用于/开发以应对抗疟药耐药性的药物的耳毒性。建议评估药物安全性的随机试验客观地测量和报告耳毒性听力损失作为不良事件。