Hearing loss from antibiotic or sickness?

D

Daveis

Inspired
Been sick a few weeks ago. Seemed like bad cold or flu. I ended up with a bad sore throat and took some leftover azithromycin(Z-Pack) to clear up my throat. Pain in my ear subsided and I got better except for this feeling of pressure and fullness in my ear. Over I’d say 2 days I lost all hearing in my left ear. Went to my general doctor a week later and was prescribed 40mg/daily prednisone plus flonase. Some pressure has been reliieved in ear but about 90% of my hearing especially high frequences are still gone in that ear. Doctor checked for wax buildup and didn’t see any. Nor did she see any redness or infection.

Can z-pack antibiotic harm hearing suddenly? I’ve used it in the past several times and it always worked quickly to knock out prior sicknesses. Is this worth getting a referral to an ENT right away? Has anyone suddenly lost hearing in an ear from a sickness or prescription med?

I was so careful over the past 25 years wearing earplugs.
 
Probably fluid buildup behind your eardrum from the sinus issues. That can definitely affect your hearing and make things sound very muffled and quiet. The prednisone and Flonase should help reduce any inflammation and help it to drain on its own. Sinus decongestant can sometimes help too.
 
A quick Google search yielded this!

"Azithromycin, an azalide antibiotic, (rarely causes) ototoxicity. According to the few reports in existence, azithromycin-induced ototoxicity occurred following prolonged high-dose therapy in patients with acquired immunodeficiency syndrome and resulted in a reversible sensorineural hearing loss."

I'm not a Doctor so I have no idea just offering up some basic info. If 40mg a day is considered a high dose it sounds plausible. I have a wicked case of Tinnitus that has come on in the last few years that has progressed pretty rapidly in my left ear. But instead of killing the highs it has knocked all of the lowes to almost nothing, this really took off after contracting COVID.
 
A trick an ENT showed me when I was a kid with lots of ear issues was to manually pop my own ears. Pinch your nose and close your mouth and then blow like you are going to blow your nose. Start softly and slowly work up the force/pressure. If it hurts, you're doing it too hard. The pressure can force a bit of air into your middle ear and allow some of the fluid to drain. Moving your jaw a lot and pulling on your ears gently can also sometimes help too by stretching the tissues in that area to work stuff loose.
 
mr_fender said:
A trick an ENT showed me when I was a kid with lots of ear issues was to manually pop my own ears. Pinch your nose and close your mouth and then blow like you are going to blow your nose. Start softly and slowly work up the force/pressure. If it hurts, you're doing it too hard. The pressure can force a bit of air into your middle ear and allow some of the fluid to drain. Moving your jaw a lot and pulling on your ears gently can also sometimes help too by stretching the tissues in that area to work stuff loose.
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The same will also let you know if you have fluid in your middle ear as well as you will hear it flowing back and forth in the eustachian tube!
 
Yeah I used to have fluid in my ears frequently as a kid. I had tubes put in several times. Once the ENT showed me how to pop my own ears, I haven't had an issue with it since (also probably outgrew it as some point which is common too). I do it all the time out of habit now. Some days when my ears feel a bit plugged up, I'll get a good loud audible pop in my ears and then everything sounds really loud and crisp until my ears/brain adjust again.
 
Eustachian tubes can take a long time to clear especially if they’re swollen from an infection.

The Flonase is a tiny tiny (micrograms) dose of steroids… That takes time to reduce inflammation, and there isn’t much there to work with.

Part of it may just be time. 👍
 
When I was taking predinisone (80mg a day) for my chronic kidney disease it affected my hearing itself. It sounded like I was standing in a wind storm all day long with constant 'rush' noise. Not the good kind of Rush noise. It was probably hearing my own blood flow or something like that but it was gnarly. Made my tinnitus seem pretty quiet in relation.
 
I'm super into ear care as I have some problems I need to manage. Wear a light hat to keep your ears warm from the outside. Drink more water than you think you need. Avoid caffeine, alcohol and other diuretics. Use a little eucalyptus oil in a hot shower a few times a week. Hot pepper also helps increases circulation which will help your ears and sinuses to clear out. Someone above mentioned the "valsalva" technique of blowing to clear your ears—pilots and divers know it well. Just be careful as the line between effective and overkill is very fine.

PS: Avoid those ultrasonic toothbrushes that emit a loud high whine that conducts through your facial bones. I think they cause more harm than good including irritation.
 
There are some strong antibiotics, chemo drugs etc that can be ototoxic, meaning they can damage hearing, but something like just a Zpack wouldn’t, we’re are talking like strongest hospital administered IV stuff….

More than likely fluid or negative pressure in the middle ear. When the Eustachian tube gets impeded, often due to sinus issues, the middle ear can create a vacuum effect which sucks the ear drum in, dampening the movement, and reducing hearing. Sort of the opposite of being at high elevation where the middle ear pressure is greater and balloons outward, again dampening sound.

Often times the negative pressure can cause some fluid weeping as well. Fluid doesn’t automatically mean infection btw. Bit fluid does again damped the ear drum and that brings the hearing down

Can say any of this for certain without seeing a patient, performing a tympanogram and such, but this is pretty much what it is in like 99% of cases

Just had a guy today, ear felt plugged up, hearing was down in that ear, PCP said it looked clear, no wax. Did a tymp and the ear drum basically had zero give, meaning a lot of fluid behind it.
 
Dude, get to an ENT as fast as you can - time is of the essence. You might be suffering from auto-immune related sensorineural hearing loss. The treatment for that sounds scary (injections of methyl prednisone through the eardrum) but it is mostly painless and easy to tolerate. An ENT can examine and advise, the injections, if recommended can possibly save permanent damage to your hearing. Take it from me - been there, lost one ear (totally, seemingly permanently), saved the other. I have probably had 20 steroid injections - no big deal.
 
@SJB I was reading that the most successful treatment is a mix of oral and injected steroid. Think I’ll call my general doc to get me a referral. This is important enough to get a second opinion.
 
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Sixstring said:
. I have a wicked case of Tinnitus that has come on in the last few years that has progressed pretty rapidly in my left ear. But instead of killing the highs it has knocked all of the lowes to almost nothing, this really took off after contracting COVID.
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Sorry to hear that. Yeah that might be what I had 2-3 weeks ago.
 
lqdsnddist said:
but something like just a Zpack wouldn’t, we’re are talking like strongest hospital administered IV stuff….
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Good point. I found out a friend was on longterm zpack and no effect on hearing. I’m thinking I have a eustacian tube malfunction. I can’t get the problem ear to pop at will like I can the right ear. Will probably call my PCP tomorrow to see about a steroid injection.
 
Daveis said:
Good point. I found out a friend was on longterm zpack and no effect on hearing. I’m thinking I have a eustacian tube malfunction. I can’t get the problem ear to pop at will like I can the right ear. Will probably call my PCP tomorrow to see about a steroid injection.
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Sounds like a good plan, but make sure to rule out any conductive pathology before going through the trans-tympanic route. Keep in mind too that usually the time frame for those is ASAP, so if it’s been a month that window might have closed. Still can do it, but it’s a lot to go through with little expected gain. Again though, I think your dealing with more of a mechanical issue with the middle ear opposed to Sudden sensory neural hearing loss. Very fact you can’t equalize pressure in that ear. Keep us posted
 
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