Which of the following antibacterial causes both ototoxicity and nephrotoxicity :
First, the core concept here is the adverse effects of certain antibiotics. The question is testing knowledge about drugs that can damage both the ear and the kidneys. The main antibiotics known for these toxicities are aminoglycosides like gentamicin, tobramycin, and amikacin. These are known for their ototoxic and nephrotoxic side effects. Then there's also polymyxin B and colistin, which can cause nephrotoxicity, but I think they're less associated with ototoxicity. Vancomycin can cause nephrotoxicity, but not typically ototoxicity. So the aminoglycosides are the primary suspects here.
Now, why the correct answer is right. Aminoglycosides are known to accumulate in the inner ear and kidneys, leading to damage. The ototoxicity is due to damage to the hair cells in the cochlea and vestibular system, causing hearing loss or balance issues. Nephrotoxicity is due to damage to the proximal renal tubules. The mechanism involves the accumulation of the drug in these tissues, which can lead to oxidative stress and cell death. So if the correct answer is an aminoglycoside like gentamicin, that's why it's correct.
For the wrong options, let's consider other antibiotics. For example, if the options include vancomycin, it's nephrotoxic but not ototoxic. Beta-lactams like penicillins or cephalosporins aren't known for these effects. Macrolides like erythromycin might cause ototoxicity in some cases, but not typically nephrotoxicity. Fluoroquinolones can cause tendon issues but not these two. So each wrong option needs to be explained why they don't fit.
The clinical pearl here is to remember that aminoglycosides are the classic culprits for both ototoxicity and nephrotoxicity. Also, monitoring serum levels and renal function when using these drugs is crucial to prevent toxicity.
Putting it all together, the correct answer is likely an aminoglycoside. The user mentioned the correct answer is option C, so I need to make sure that in the explanation. The options A, B, D would be other antibiotics that don't have both effects. The clinical pearl reinforces the importance of aminoglycosides in this context.
**Core Concept**
This question assesses knowledge of antibiotics with overlapping ototoxic and nephrotoxic adverse effects. Aminoglycosides are the prototypical class causing both due to their accumulation in the inner ear and renal proximal tubules.
**Why the Correct Answer is Right**
Aminoglycosides like gentamicin, tobramycin, and amikacin are ionically charged and accumulate in the high pH compartments of the inner ear and renal tubules. They cause irreversible damage to cochlear and vestibular hair cells (ototoxicity) and proximal tubular epithelium (nephrotoxicity). This toxicity is dose-dependent and exacerbated by concurrent