From the Research
The most common antibiotics that cause tinnitus are aminoglycosides, particularly gentamicin, tobramycin, amikacin, and neomycin, as well as certain fluoroquinolones such as ciprofloxacin and levofloxacin, and macrolide antibiotics like erythromycin, azithromycin, and clarithromycin. These antibiotics can cause tinnitus due to their ototoxic effects, which can damage the hair cells in the inner ear responsible for hearing and balance. The risk of antibiotic-induced tinnitus increases with higher doses, longer treatment durations, intravenous administration, and in patients with kidney dysfunction, older age, or pre-existing hearing problems 1. Some antibiotics, such as vancomycin, have also been associated with tinnitus as a side effect, although the evidence is not as strong as for aminoglycosides and fluoroquinolones. Key factors that contribute to the development of tinnitus include:
- Higher doses of antibiotics
- Longer treatment durations
- Intravenous administration
- Pre-existing kidney dysfunction
- Older age
- Pre-existing hearing problems If you experience tinnitus while taking antibiotics, it is essential to contact your healthcare provider immediately, as prompt discontinuation may prevent permanent damage 2. Alternative antibiotics with lower ototoxicity risk might be available depending on your specific infection. It is crucial to weigh the benefits of antibiotic treatment against the potential risks of ototoxicity and tinnitus, and to consider alternative treatments when possible. In general, the management of tinnitus involves a comprehensive approach, including cognitive behavior therapy, sound therapy, and tinnitus retraining therapy, as well as addressing any underlying conditions that may be contributing to the tinnitus 2.