title: No hearing loss associated with the use of artemether-lumefantrine to treat experimental human malaria.
abstract: Artemisinin derivatives are becoming the first-line treatment for uncomplicated malaria in areas with widespread resistance to chloroquine. Although generally safe and well tolerated, it has been suggested from animal experiments, and more recently from one human study with artemether-lumefantrine, that these compounds are potentially neurotoxic, affecting particularly the brainstem auditory pathways. We report here the auditory analyses of 15 volunteers who underwent an experimental human malaria infection and were treated with artemether-lumefantrine. The subjects underwent audiological examination before the start of the study, during infection, and after treatment. Examination included standard tone audiometry, high frequency tone audiometry and auditory brainstem response (ABR). No effects on hearing loss that were deemed to be caused by drug treatment were found using tone audiometry. ABR analysis similarly failed to demonstrate any auditory pathway damage in the volunteers after treatment. We have thus not found any clear evidence of a detrimental effect on the auditory system by artemether-lumefantrine treatment in uncomplicated malaria. Our results support the continued implementation of artemisinin derivatives in the fight against drug-resistant malaria.
authors.affiliation: Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Matthew B B
authors.initials: MB
authors.lastname: McCall
authors.forename: Andy J
authors.initials: AJ
authors.lastname: Beynon
authors.forename: Emmanuel A M
authors.initials: EA
authors.lastname: Mylanus
authors.forename: Andre J A M
authors.initials: AJ
authors.lastname: van der Ven
authors.forename: Robert W
authors.initials: RW
authors.lastname: Sauerwein
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000009:adverse effects*; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D004338:Drug Combinations; D004983:Ethanolamines / Q000009:adverse effects*; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D005449:Fluorenes / Q000009:adverse effects*; D034381:Hearing Loss / Q000139:chemically induced*; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male
chemical_list: D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes