Which adverse effect is most commonly associated with aminoglycosides?

• A. Nephrotoxicity.
• B. Hepatotoxicity.
• C. Pulmonary fibrosis.
• D. Severe hypotension.

Answer: (A)

Aminoglycosides are most commonly linked to nephrotoxicity because they are filtered by the kidneys and can accumulate in proximal tubular cells, causing dose-related acute kidney injury. This risk increases with longer treatment, higher trough levels, preexisting kidney disease, advanced age, and concurrent use of other nephrotoxic drugs. Monitoring kidney function (creatinine, estimated GFR) and trough levels helps guide dosing and minimize harm, with adjustments or drug cessation often reversing the damage. While other adverse effects like ototoxicity can occur with aminoglycosides, they are not the most common issue listed here, and hepatotoxicity, pulmonary fibrosis, or severe hypotension are not typical associations with this drug class.