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|Title: ||Long Term Streptomycin Toxicity in the Treatment of Buruli Ulcer: Follow-up of Participants in the BURULICO Drug Trial|
|Authors: ||Stienstra, Ymkje|
Phillips, Richard O.
Abass, Kabiru Mohammed
Werf, Tjip S. van der
|Issue Date: ||13-Mar-2014|
|Publisher: ||PLOS Neglected Tropical Diseases|
|Citation: ||PLoS Negl Trop Dis 8(3): e2739. doi:10.1371/journal.pntd.0002739|
|Abstract: ||Background: Buruli Ulcer (BU) is a tropical infectious skin disease that is currently treated with 8 weeks of intramuscular
streptomycin and oral rifampicin. As prolonged streptomycin administration can cause both oto- and nephrotoxicity, we
evaluated its long term toxicity by following-up former BU patients that had received either 4 or 8 weeks of streptomycin in
addition to other drugs between 2006 and 2008, in the context of a randomized controlled trial.
Methods: Former patients were retrieved in 2012, and oto- and nephrotoxicity were determined by audiometry and serum
creatinine levels. Data were compared with baseline and week 8 measurements during the drug trial.
Results: Of the total of 151 former patients, 127 (84%) were retrieved. Ototoxicity was present in 29% of adults and 25% of
children. Adults in the 8 week streptomycin group had significantly higher hearing thresholds in all frequencies at long term
follow-up, and these differences were most prominent in the high frequencies. In children, no differences between the two
treatment arms were found. Nephrotoxicity that had been detected in 14% of adults and in 13% of children during
treatment, was present in only 2.4% of patients at long term follow-up.
Conclusions: Prolonged streptomycin administration in the adult study subjects caused significant persistent hearing loss,
especially in the high frequency range. Nephrotoxicity was also present in both adults and children but appeared to be
transient. Streptomycin should be given with caution especially in patients aged 16 or older, and in individuals with
concurrent risks for renal dysfunction or hearing loss.|
|Description: ||An article published by PLOS Neglected Tropical Diseases|
|Appears in Collections:||College of Health Sciences|
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