A 55-year-old female was admitted to ICU 8 days ago after suffering burns \ Currently she is febrile with 102 degree F. Blood cultures were obtained with following finding. The Doctor on duty is worried about a blood infection and plans to sta with empiric combination therapy containing aminoglycosides directed against Pseudomonas aeruginosa. Old usg record of the patient is shown below: The patient could not come for follow up due to lockdown. The doctor, currently is concerned about nephrotoxicity profile of the drugs. Which of the following drug is most safe?

Usg shows raised renal coical echogenecity suggestive of renal parenchymal disease and therefore should avoid aminoglycosides. All aminoglycosides have complication of being ototoxic and nephrotoxic. Ototoxicity and nephrotoxicity are more likely : when therapy is continued for > 5 days at higher doses Elderly renal insufficiency. Concurrent use with loop diuretics or other nephrotoxic antimicrobial agents (eg, vancomycin or amphotericin. Ototoxicity is most likely seen with: Neomycin Kanamycin amikacin vestibulotoxic agent- Streptomycin gentamicin nephrotoxic agents: Neomycin Tobramycin gentamicin