Safest Non-Ototoxic Antibiotic?

[sgal]

Hi, it's been a long time since I've been here. There's nothing like another health crisis in another part of your body to take your mind off of tinnitus and that's where I've been. I'm actually doing very well with the tinnitus. My story is that my tinnitus spiked last January in response to a bad virus and possibly a strong antibiotic I was on for a while. I'm happy to report that it has calmed down a great deal. However, I had hardly found my footing when another health issue developed. I'm having surgery for that issue on Wed. of this week. It's not life threatening but a bit personal to talk about. My question is, if you are allergic to the pencillin class of drugs, what is your safest bet for an antibiotic in terms of protecting your hearing and not making your tinnitus worse?

Thanks everyone, after I recover from surgery, I'll tell you more about the tinnitus journey I've been on.

 

[kharaa]

It varies on the type of infection, certain antimicrobials are better against different kinds of bacteria.. the ones to avoid are the micin/mycin class of antibiotics, they are usually horrifically ototoxic. (This is not definitive, but many of them are ototoxic.)

Are you allergic to just penicillian or also amoxicillian and other drugs of the class?

from Dr Red Moser on WebMD said this about penicillian allergies..

Medical providers have always been taught that if you are allergic to penicillin, you have a greater chance of also being allergic to a large class of antibiotics called cephalosporins (Keflex, Suprax, Omnicef, Cefzil, Ceftin, etc.). Not wanting to cause the patient another, potentially-serious adverse reaction, many clinicians automatically eliminate cephalosporin use in patients who report a penicillin allergy. A study of 156 penicillin-allergic patients reported at the American Academy of Allergy, Asthma, and Immunology, found that 80 people tested negative to penicillin allergy, and only ONE PATIENT out of 156 experienced a possible, mild adverse reaction.
TIP #2: Not all adverse reactions to drugs, even rashes, are ALLERGIC. Amoxicillin ? a penicillin derivative ? is notorious for causing a non-allergic, skin rash in some people. Clinicians typically will avoid giving it again, but to eliminate cephalosporins as an alternative drug may not be prudent.
TIP #3: Viruses often cause rashes, especially in children, so if a child is taking amoxicillin and develops a rash, it does not necessarily mean it is from the drug. However, if a child develops HIVES, this is most-likely a penicillin allergic response.

TIP #4: Not all adverse reactions are ALLERGIC reactions. Getting a tummyache or diarrhea while taking an antibiotic does not mean you are "allergic" to it.

Always inform your medical provider of possible allergies AND adverse drug reactions so that a reasonable, informed decision can be made regarding the use of the same or similar medications in the future.

 

[Grace]

Honestly ive been wondering the same thing and have asked on here multiple times and the answers i get are basically that there are none other then the ones that are in the pennicillin category.. So most likely we will get a mycin when we come across these issues ugh. I just had a bladder infection that went away on its own cause i refused to call the doc cause i know what they would of put me on but im goin to an allergist and am gonna get tested for a pennicillin alergy cause i might have outgrown it.. Are you 100% sure your alergic to pennicillin? Cause if you were a kid when you had the allergy then you might of outgrew it.. If you google it they said only like 5 people out of like 1000 are actually alergic to it but a skin alergy test will be the only way to find out.

 

[Dr. Nagler]

Honestly ive been wondering the same thing and have asked on here multiple times and the answers i get are basically that there are none other then the ones that are in the pennicillin category.

Interesting.

So my responses don't count?

stephen nagler

 

[Grace]

You said to take a mycin if needed ans try not too worry what it might be able to do cause in the longrun almost everything is ottoxic but im not at that point yet!! My T is at bay and i wouldnt be able to forgive myself if i took one and had a permanent T increase. But i did alot of googling and there really isnt any safe drug other then the cillins, well that i know of at least. I know if you take a mycin doesnt mean its definally gonna cause an increase but just that chance and we were all dealt shitty luck in the first place right? But thanks for your response i wish i could have the mindset of you!

 

[Dr. Nagler]

I said that in the long run almost everything is ototoxic? Really? I said that?

stephen nagler

 

[Karen]

I'm one of those people who is allergic to penicillin and amoxicillin (I had an anphylactic reaction to amoxicillin about 20 years ago, and have avoided those drugs ever since).

I have taken Azithromycin (Z-pack) for an infection without any problems. My tinnitus and pulsatile tinnitus did not get any worse. This may not be the case for everyone, but it did work for me.

 

[Grace]

I said that in the long run almost everything is ototoxic? Really? I said that?

stephen nagler

Everything and anything can cause tinnitus or make it worse which is true.. Not that its gonna, but theres that chance.

 

[Dr. Nagler]

@Grace, just because something might temporarily aggravate tinnitus doesn't make it ototoxic. Ototoxic means causes auditory damage. And very few antibiotics potentially cause auditory damage.

If you devote yourself to avoiding anything and everything that might temporarily aggravate your tinnitus, you will paint yourself into a corner and become for all intents and purposes paralyzed, allowing your tinnitus to dictate your life. Your tinnitus will be driving your bus!

My suggestion? Devote yourself instead to driving your own bus. Put your tinnitus in the back seat. In fact, don't even give it a ride!

Dr. Stephen Nagler

 

[Grace]

@Grace, just because something might temporarily aggravate tinnitus doesn't make it ototoxic. Ototoxic means causes auditory damage. And very few antibiotics potentially cause auditory damage.

If you devote yourself to avoiding anything and everything that might temporarily aggravate your tinnitus, you will paint yourself into a corner and become for all intents and purposes paralyzed, allowing your tinnitus to dictate your life. Your tinnitus will be driving your bus!

My suggestion? Devote yourself instead to driving your own bus. Put your tinnitus in the back seat. In fact, don't even give it a ride!

Dr. Stephen Nagler

Im workin on it! Its just everyone on here swears on not taking any mycin drug.. And a few on here has had permanent increases in T after taking a mycin so thats why im just scared.

 

[Dr. Nagler]

And a few on here has had permanent increases in T after taking a mycin so thats why im just scared.

Let's step back for a minute.

The only drugs I can think of that end in "-mycin" are the aminoglycoside antibiotics. And they have ototoxic potential only when given by vein. Why would an aminoglycoside antibiotic be given by vein? They are given by vein for life-threatening infections, in which case - yes - they do have ototoxic potential. They are also sometimes used in ear drops, in which case they have ototoxic potential only if your eardrum is perforated - - but doctors do not prescribe them to people with perforated eardrums!!! In the cases of those who developed a permanent increase in tinnitus after being administered, say, neomycin ear drops ... the increase was due to the infection that resulted in the prescription rather than to the prescription itself. Unless, of course, their doctor never bothered to look in their ears to make sure their eardrums were not perforated!

All the best -

Dr. Stephen Nagler

 

[Lisa88]

A UCSF ENT known for his work on tinnitus at UCSF told me that practically every drug has the potential to cause tinnitus to those vulnerable to it. Interesting.
Note, as Dr. Nagler states above, this is different to the word "ototoxic". This often is a term that gets confused.

 

[Dr. Nagler]

A UCSF ENT known for his work on tinnitus at UCSF told me that practically every drug has the potential to cause tinnitus to those vulnerable to it.

Right. But so does practically every food.

Plus, it's a moving target. One day a drug might aggravate your tinnitus ... and the next day it might not.

What I am saying here, my friends, is that it all comes down to how you are going to conduct your life. And if you devote yourself to meticulously avoiding anything and everything that might possibly aggravate your tinnitus, it's not going to be much of a life at all.

In my opinion, anyway.

Dr. Stephen Nagler

 

[Lisa88]

Right. But so does practically every food.

Plus, it's a moving target. One day a drug might aggravate your tinnitus ... and the next day it might not.

What I am saying here, my friends, is that it all comes down to how you are going to conduct your life. And if you devote yourself to meticulously avoiding anything and everything that might possibly aggravate your tinnitus, it's not going to be much of a life at all.

Dr. Stephen Nagler

I really understand what you say to be true, Dr. Nagler. My tinnitus onset was triggered by lidocaine anesthetic nose spray. The ENT said that in his 40 years practicing, he had never seen such a thing. Other ENTs said similar things. The dose was very small compared to intravenous anesthetic, but yet I was still vulnerable to it at that particular time and at that small dose. Had a menstrual migraine and considerable anxiety at the time, which could have been contributing factors. But nobody knows. I have since found out that so much has potential to cause or aggravate t, even an orgasm. Crazy! If there is vulnerability somewhere in the auditory system, including the brain's central auditory cortex, there is potential for t I would think.

 

[Dr. Nagler]

I really understand what you say to be true, Dr. Nagler. My tinnitus onset was triggered by lidocaine anesthetic nose spray.

Just out of curiosity, why was the lidocaine anesthetic nose spray administered, and how long after the spray was administered did it take for your tinnitus to develop?

Dr. Stephen Nagler

 

[Grace]

Let's step back for a minute.

The only drugs I can think of that end in "-mycin" are the aminoglycoside antibiotics. And they have ototoxic potential only when given by vein. Why would an aminoglycoside antibiotic be given by vein? They are given by vein for life-threatening infections, in which case - yes - they do have ototoxic potential. They are also sometimes used in ear drops, in which case they have ototoxic potential only if your eardrum is perforated - - but doctors do not prescribe them to people with perforated eardrums!!! In the cases of those who developed a permanent increase in tinnitus after being administered, say, neomycin ear drops ... the increase was due to the infection that resulted in the prescription rather than to the prescription itself. Unless, of course, their doctor never bothered to look in their ears to make sure their eardrums were not perforated!

All the best -

Dr. Stephen Nagler

Okay thankyou for that, im gonna try and not worry then say if i get strep throat, or the flu and have to take a mycin... Its crazy cause i havent needed an antibitoic since i was like 10 and that was 13 years ago.. I rarely get sick but im older now. I still wanna get rechecked for a pennicillin alergry cause that does treat alot of infections with less side effects, so if im not alergic anymore great but if so ill try not to worry.

 

[sgal]

Hello everyone and thank you for the responses. Thanks Karen, I think I have taken Azithromycin without problems before. I actually did have an allergy test for ampicillin last summer. It had been about 20 years since I had had a reaction. The test was negative for ampicillin reaction. The thing is, I'm having surgery tomorrow and I'm not sure that is the right place to test drive my new clearance on the penicilli drug class.

 

[Dr. Nagler]

Hello everyone and thank you for the responses. Thanks Karen, I think I have taken Azithromycin without problems before. I actually did have an allergy test for ampicillin last summer. It had been about 20 years since I had had a reaction. The test was negative for ampicillin reaction. The thing is, I'm having surgery tomorrow and I'm not sure that is the right place to test drive my new clearance on the penicilli drug class.

Earler I said that the only "-mycin" antibiotics I could think of were the aminoglycosides. I forgot about azithromycin. Azithromycin is not an aminoglycoside and is not ototoxic. Still and all, azithromycin is the only non-ototoxic antibiotic I feel that tinnitus sufferers should avoid if at all possible. I know of just too many anecdotal accounts of people developing permanent tinnitus after taking that particular drug to risk it.

Erythromycin is another "-mycin" that slipped my mind. Erythromycin is not an aminoglycoside. I have no problem with erythromycin by mouth, but I would be concerned about intravenous administration.

My apologies for any confusion here.

Dr. Stephen Nagler

 

[Shadgirl]

Don't know if the Dr is still watching this thread but if he is and he's got the time, I have chronic ear infections and that vary drug, azithromycin was proscribed! I took the first dose yesterday and nothing happened, and I'm waiting to see what the second dose I just took will do. Dose one was bigger then the others, but am I in danger of a tinnitus nightmare hear? Its the only thing I think my doctors know to give me at this point!!

 

[NiNyu]

@Shadgirl , a friend is taking 200mg of doxycycline a day. Before he was taking 1000mg of ciprofloxacin. Both are non-ototoxic antibiotics. But there's also cefaclor and amoxicillin.

You won't get any ear damage from taking azithromycin twice.

 

[BuzzPete]

Hi Dr Nagler--You indicated that an aminoglycoside (e.g., neomycin as part of neo-poly-dex mix) would increase tinnitus only if introduced by vein. Would that drug entering the tear duct and thus into the blood stream be equivalent to systemic introduction via the vein?

 

[The_T]

Wish I had come across this thread earlier.

My doctor gave me azithromycin and now I think my T is worse. Is it anything I can do now? Im dying from sadness...

 

[JohnK]

@Shadgirl , a friend is taking 200mg of doxycycline a day. Before he was taking 1000mg of ciprofloxacin. Both are non-ototoxic antibiotics.

Doxycycline is otoxic for me!

 

[Natalie Roberts]

If you've used a drug before with no ill effects and are required to use the same type of drug for health reasons is your risk of further affecting your tinnitus lower? For example, Penicilin may be required for my birth and if so, I have used it in the past with no ill effects. Should I therefore not be as concerned about a reaction or should I understand basically any drug can cause an increase/effect in Tinnitus and to use the drug if the benefits outweigh the risks?

 

[Yves]

Just took doxycycline for a sinus infection. Only two 100mg caps were enough to rekindle my tinnitus substantially.
Needless to say I stopped taking it. But I do not know when the hissing will abate
Everybody will need antibiotics at some point, most MDs have no clue about this issue, so i feel i have to suggest them which antibiotic is the most tinnitus neutral...

 

[Lyn Harvey]

Hi. I am 64 yr old female T for 18months. Cannot sleep at all. Tried Mertazapine now off that temazapan, restavil, Belsomra (dont bother waste of money that one) melatonin no help and am scared that Temaz is addictive and ototoxic. Are the Z drugs any better or anyone any ideas. I need something for the rest of my life as this is hell not sleeping.

 

[lymebite]

One resource to consult is this guide:

"European Review for Medical and Pharmacological Sciences: Pharmacological drugs inducing ototoxicity, vestibular symptoms and tinnitus: a reasoned and updated guide"

http://www.europeanreview.org/wp/wp-content/uploads/956.pdf

Fluorquinolone antibiotics perhaps are especially risky:

https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm513183.htm

 

[KLambert]

Hi. I am 64 yr old female T for 18months. Cannot sleep at all. Tried Mertazapine now off that temazapan, restavil, Belsomra (dont bother waste of money that one) melatonin no help and am scared that Temaz is addictive and ototoxic. Are the Z drugs any better or anyone any ideas. I need something for the rest of my life as this is hell not sleeping.

Ask your doctor for amitryptiline. It helps me sleep and reduces my anxiety.

 

[tacbaloon]

Doxycycline is otoxic for me!

At what dose?