Gentamicin exerts its bactericidal action by binding to the bacterial 30S ribosomal subunit, leading to the disruption of protein synthesis. However, its affinity for certain cellular structures in the human body, particularly in renal tubular cells and inner ear hair cells, can lead to toxicity. In the kidneys, gentamicin accumulates in the proximal tubule cells, causing mitochondrial damage and oxidative stress, ultimately leading to cell death and kidney dysfunction. Similarly, in the ear, it affects the hair cells in the cochlea and vestibular apparatus, leading to hearing loss and balance disorders.
