Which pairing of aminoglycoside with its predominant pattern of ototoxicity is correct?

• A Amikacin: predominantly vestibular damage
• B Neomycin: predominantly cochlear damage ✓
• C Streptomycin: predominantly cochlear damage
• D Tobramycin: predominantly cochlear damage

Explanation

Neomycin is the most cochleotoxic aminoglycoside, which is why systemic use is abandoned and it is restricted to topical and bowel preparation use. Gentamicin, tobramycin and streptomycin cause predominantly vestibular toxicity, while amikacin causes mainly cochlear (high-frequency hearing loss) toxicity. Recognising this split predicts which symptom, deafness versus vertigo and ataxia, a given drug will produce.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.