Aminoglycosides are among the most frequently used antibiotics in pediatric inpatient care for infections involving gram-negative organisms. Clinical situations that warrant aminoglycoside usage may include prophylaxis and treatment of sepsis and pneumonia for neonatal and pediatric populations, kidney and urinary tract infections in children of all ages, and serious pulmonary infections for patients with cystic fibrosis. Even so, the overwhelming majority of children never receive these drugs during their lifetimes, and it is usually impossible to predict beforehand which children are going to need them. When a child presents with signs of the sort of serious bacterial infections that warrant the use of aminoglycoside therapy, the typical practice is to start antibiotic therapy while awaiting cultures for confirmation. Waiting 1 to 2 weeks to receive the genetic test results before starting therapy would not be in the best interest of the patient in most cases. The damage from the drug is likely to have occurred before the genetic test results are returned. Thus, it is unlikely that this test will avert the risk of ototoxicity in the acute setting. Furthermore, drawing 8.5 mL of whole blood, the amount requested by Athena Diagnostics, Inc, from an infant is infeasible. While testing in some settings could be accomplished with a smaller volume of blood, and completed in several hours, access to this technology is not widely available. The time frame of hours may still be too long to wait when considering antibiotic therapy. By contrast, obtaining a maternal family history of aminoglycoside-induced ototoxicity, while somewhat less sensitive, could be accomplished promptly and direct the practitioner to select another form of therapy if available.