This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Chemotherapy, Subject name: Pharmacology
Which of the following aminoglycosides has highest nephrotoxicity? 
Select and explain. 
A. Paramomycin, B. Streptomycin, C. Amikacin, D. Neomycin
D: Neomycin
Answer: D: Neomycin 
Explanation: Small amounts that are absorbed from the gut or topical sites are excreted unchanged by kidney. This may accumulate in patients with renal insufficiency-cause fuher kidney damage and ototoxicity. Neomycin is contraindicated if renal function is impaired. ESSENTIALS OF MEDICAL PHARMACOLOGY page 750