Objective: The objective of this study was to clarify the incidence and course of hearing loss after bacterial meningitis to optimize the audiological follow-up. Data Sources: The databases Embase, Medline (OvidSP), Web-of-science, Scopus, Cinahl, Cochrane, PubMed publisher, and Google Scholar were used. Only articles written in English were included. Study Selection: Articles published from 1985 until March 2015 describing the incidence, risk factors, or course of hearing loss after meningitis were used. Data Extraction: The quality of the studies was assessed on three aspects: quality of audiometry, number of patients, and methodological quality. Data Synthesis: For each publication, data were entered in spreadsheet software for analysis. The data were analyzed and interpreted using best evidence synthesis. Conclusions: The overall quality of the included studies was poor. A major drawback was the quality of the (description of) audiometry, severity, and timing of hearing loss. A systematic review of the literature showed an incidence of hearing loss (>25 ± 5 dB) of 14% and an incidence of 5% for profound hearing loss (>90 dB). Patients with initial normal hearing after meningitis showed stable normal hearing over time. However, initial hearing loss related to meningitis can improve or deteriorate over time. We therefore recommend early audiological testing of all patients who suffered bacterial meningitis. However, long-term audiological follow-up is only needed for patients with early onset hearing loss and not for patients with normal hearing at the first hearing test.
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