Hearing loss associated with imipenem/cilastatin: a case report and literature review

Abstract Background Imipenem/cilastatin is an important carbapenem antibiotic widely used for the treatment of severe infections and those caused by multidrug-resistant bacteria. Neurological adverse reactions are relatively common, whereas hearing loss has rarely been reported. Case presentation We report a 75-year-old patient with liver cancer and liver cirrhosis complicated by abdominal infection who developed subjective, not objectively confirmed right-sided hearing loss within 24 h after initiation of imipenem/cilastatin. After discontinuing imipenem/cilastatin, the patient’s hearing gradually improved, while concomitant medications including furosemide were continued. Conclusions This case suggests a possible association between imipenem/cilastatin exposure and subjective hearing loss, based on the WHO-UMC system and the Naranjo scale. However, causality cannot be established with certainty because no objective audiological assessment was performed and the presence of alternative explanations, particularly concomitant furosemide exposure cannot be excluded. This case highlights a potential, but unconfirmed, ototoxicity signal associated with imipenem/cilastatin and warrants further clinical attention and investigation.