Sensorineural hearing loss as a probable serious adverse drug reaction associated with low-dose oral azithromycin

J Otolaryngol. 2007 Oct;36(5):257-63. doi: 10.2310/7070.2007.0047.


Background: Hearing loss as a possible side effect of azithromycin has been recognized since 1994. Most reports suggesting a link between sensorineural hearing loss (SNHL) and this drug have been in association with prolonged doses for treatment of Mycobacterium lung disease. Mild-moderate, gradual, and reversible SNHL in the speech frequencies has been most often reported.

Materials and methods: We describe irreversible SNHL in a patient in association with low-dose oral azithromycin prescribed for acute otitis media. We summarize the available evidence, including a systematic literature review, in support of a possible causal association between SNHL and low-dose azithromycin therapy.

Interpretation/discussion: Physicians should be aware of the potential for even low-dose, oral azithromycin to cause irreversible SNHL as a serious adverse drug reaction in some patients.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Azithromycin / administration & dosage
  • Azithromycin / adverse effects*
  • Female
  • Hearing Loss, Sensorineural / chemically induced*
  • Hearing Loss, Sensorineural / diagnosis
  • Humans
  • Middle Aged
  • Otitis Media / complications
  • Otitis Media / drug therapy


  • Anti-Bacterial Agents
  • Azithromycin