Which of the following medications is known to cause ototoxicity?

Aspirin is known to cause ototoxicity, which refers to hearing damage due to chemical agents. Ototoxicity can manifest as tinnitus (ringing in the ears) or hearing loss, especially at higher doses or with prolonged use. Aspirin interferes with the normal function of the auditory system by affecting blood flow to the cochlea and causing alterations in the inner ear fluid balance. Due to these mechanisms, individuals taking high doses or those who may be more sensitive can experience auditory side effects.

In contrast, the other medications mentioned do not have a widely recognized association with ototoxicity. Paracetamol is primarily an analgesic and antipyretic with a good safety profile related to the ear. Amoxicillin, an antibiotic, is used to treat a range of infections without noted toxic effects on hearing. Ibuprofen, although a non-steroidal anti-inflammatory drug (NSAID) that can potentially have side effects, is generally not associated with ototoxic effects under normal circumstances. Thus, aspirin stands out in this context as a medication that specifically has the potential to cause ototoxicity.