Universitas Indonesia Conferences, Asian Federation for Pharmaceutical Sciences (AFPS) 2019

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Kanamycin Otoxicity in Drug Resistance Tuberculosis: A Drug Use Evaluation Study
Achdi Kurnia, Purwantyastuti Purwantyastuti, Instiaty Instiaty

Last modified: 2019-06-17


Background:Kanamycin is part of the drug regimen administered to multidrug resistant tuberculosis (MDR-TB) patients and has the potential to cause ototoxicity.Objectives:This study aimed to asses the occurence of kanamycin ototoxicity and factors that influence  the event in patients with drug resistant TB. Material and Methods:A retrospective cohort study was conducted using data from medical records of drug-resistant TB patients at a Private Hospital in Jakarta, Indonesia, during the period of 2016 to 2018. Patients diagnosed with drug resistant TB  with normal audiometry at base line and received kanamycin injection as part of the MDR-TB regimen were included. Results:Of 72 drug resistant TB patients who received kanamycin, 23 experienced ototoxicity (31.9%). In 56.5% of ototoxicity cases, the onset occured within the first three months of treatment. The earliest onset determind by audiometry was at day 5 and the latest was at the 10thmonth of treatment. The incidence of ototoxicity in male patients (21%) was significantly less than in female (44.1%) (RR: 0.477, 95% CI: 0.232-0.983, p=0.036). There were no significant association between diabetes mellitus co-morbidity (p=0.199), age (p=0.05), previous use of streptomycin (p=0.721), and kanamycin dose (p=0.425) with the development of ototoxicity. Conclusions:More than 30% of drug resistant TB patients who received kanamycin developed ototoxicity, which  become a big concern for the continuation of its use as part of the MDR-TB drug regimen. In this study, diabetes mellitus, age, history of streptomycin use, and kanamycin dose had no association with the development of kanamycin ototoxicity.


Keywords:Drug resistant tuberculosis, kanamycin, ototoxicity, diabetes mellitus