What are the two most concerning adverse effects of aminoglycosides?

Aminoglycosides are a class of antibiotics known for their efficacy against certain types of bacteria, particularly gram-negative infections. However, their use is often limited by their potential for serious adverse effects, with nephrotoxicity and ototoxicity being the most concerning.

Nephrotoxicity refers to damage to the kidneys, which can lead to renal impairment, increased serum creatinine levels, and potentially acute kidney injury. This is particularly relevant with aminoglycosides because the drug can accumulate in kidney tissues, resulting in toxic effects. Consequently, renal function should be closely monitored during treatment, especially in patients with pre-existing renal conditions or those on prolonged therapy.

Ototoxicity, another significant adverse effect, involves damage to the auditory and vestibular structures within the ear. It can lead to hearing loss or balance disturbances, which can be irreversible in some cases. The risk of ototoxicity is dose-dependent and is more pronounced when higher doses are administered or when the duration of treatment is extended.

While nephrotoxicity is a common concern among various medications, the specific combination of nephrotoxicity and ototoxicity is more characteristic of aminoglycosides, distinguishing them from other antibiotic classes that may present different risk profiles. Hence,