Antibiotics are a necessary evil for people with tinnitus. Though they should only be taken if needed, they are lifesavers. One class of antibiotics, the aminoglycosides, are well known for their ototoxity. These antibiotics end in "micin" or "mycin." But not all antibiotics with the "mycin" ending are aminoglycosides. Another class of antiobiotics, called macrolides, also end in "mycin." These are not usually associated with ototoxicity. And, if macrolides do spike your tinnitus, your noise should go back to baseline after you've stopped the antibiotics. See, for example, this reference from Wikipedia regarding the difference in ototoxcity between aminoglycides and macrolides and how you may prevent adverse reactions: Antibiotics in the aminoglycoside class, such as gentamicin and tobramycin, may produce cochleotoxicity through a poorly understood mechanism. It may result from antibiotic binding to NMDA receptors in the cochlea and damaging neurons through excitotoxicity. Aminoglycoside-induced production of reactive oxygen species may also injure cells of the cochlea. Once-daily dosing and co-administration of N-acetylcysteine may protect against aminoglycoside-induced ototoxicity. The ototoxicity of gentamicin can be exploited to treat some individuals with Ménière's disease by destroying the inner ear, which stops the vertigo attacks but causes permanent deafness. Macrolide antibiotics, including erythromycin, are associated with reversible ototoxic effects. The underlying mechanism of ototoxicity may be impairment of ion transportin the stria vascularis. Predisposing factors include renal impairment, hepatic impairment, and recent organ transplantation. Besides antibiotics, many drugs may induce tinnitus in some people. Already having tinnitus makes you more vulnerable to experiencing a spike or even permanent increase. But typically such spikes will be short term and limited. They are usually reversible. Fortunately, penicillin does not cause spikes for people with tinnitus, but not everyone can take penicillin and the drug is not effective on all types of bacteria. And so if prescribed an antibiotic that ends with a "mycin" or "micin," you should see if it is a macrolide or an aminoglycoside. As a precaution, moreover, you might protect your ears with NAC or another otoprotective supplement whenever you take antibiotics. The only antibiotic exception is penicillin, which does not seem to spike anyone's tinnitus. Like most people here, I feel all antibiotics--except for penicillin--present risk. But having some protection from ototoxicity is the best we can do to protect ourselves. Here are the Wiki articles about antibiotic classes: http://en.wikipedia.org/wiki/List_of_antibiotics http://en.wikipedia.org/wiki/Aminoglycoside Here is reference to a thread on TT that discusses NAC being used for otoprotection with antibiotics: https://www.tinnitustalk.com/threads/n-acetylcysteine.395/page-2#post-49536 And, before you take any supplement, it is always a good idea to check for potential drug interactions and side effects. Your physician and pharmacist are excellent sources. But I'd also check the internet. WebMD is very good site, and there are others. Here is a link to NAC on WebMD: http://www.webmd.com/vitamins-supplements/ingredientmono-1018-N-ACETYL CYSTEINE.aspx?activeIngredientId=1018&activeIngredientName=N-ACETYL CYSTEINE And, if still worried, see if another antibiotic class might also work. Too bad that antibiotics are no longer profitable for pharmaceutical companies, and therefore very few are being developed. And those in development or recently developed tend to be the expensive, last resort antibiotics given intravenously. I hope this information helps!