What are aminoglycosides and what toxicities must be monitored?

Aminoglycosides like gentamicin, tobramycin, and amikacin are bactericidal antibiotics that bind to the 30S ribosomal subunit and are effective against serious gram-negative infections. They require monitoring for two dose-limiting toxicities: nephrotoxicity, which causes kidney damage that is usually reversible, and ototoxicity, which causes irreversible hearing loss and vestibular damage. Peak and trough drug levels are monitored to ensure therapeutic efficacy while minimizing toxicity.