By Robert M. DiSogra

Audiologists have known about the ototoxicity of quinine (and its derivatives) and antibiotics (macrolide and aminoglycoside) for decades. But we have never seen the combined use of two drugs, each with known ototoxic potential, being used as an intervention strategy for the coronavirus pandemic (COVID-19).

In an effort to combat the coronavirus (COVID-19), front-line physicians are repurposing two drugs: hydroxychloroquine (commonly used for malaria and rheumatoid arthritis) and azithromycin (a macrolide antibiotic used to treat common infections of the respiratory system, the ear and the eye). Both drugs are known ototoxic agents; however, there is no published research about the synergistic ototoxic effects of these drugs in treating COVID-19.

At the present time, it is not known if hearing loss and/or tinnitus will be a late onset side effect of this COVID-19 drug intervention. Therefore, case history questions will need to be added to accommodate this new population of patients.

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