Which antibiotic class is known for potential ototoxicity and nephrotoxicity?

• A. Macrolides.
• B. Beta-lactams.
• C. Tetracyclines.
• D. Aminoglycosides (e.g., gentamicin).

Answer: (D)

Aminoglycosides are the antibiotic class most known for both ear (ototoxic) and kidney (nephrotoxic) toxicity. These drugs are highly effective against many Gram-negative bacteria, but they can accumulate in two critical sites: the renal proximal tubule cells and the hair cells of the inner ear. This buildup can lead to dose-related nephrotoxicity, often presenting as a rise in creatinine and reduced kidney function, and ototoxicity, which can cause irreversible hearing loss or balance issues. Because the risk increases with higher exposures and longer treatment, clinicians monitor drug levels and kidney function, use dosing strategies that limit toxicity (such as appropriate trough levels or once-daily dosing when possible), ensure good hydration, and avoid combining with other nephrotoxic drugs.

Other common antibiotic classes don’t share this same dual toxicity profile as prominently. Macrolides, beta-lactams, and tetracyclines can have side effects, but they are not characteristically linked to both ototoxicity and nephrotoxicity in routine practice.