Aminoglycosides are cidal inhibitors of bacterial protein synthesis that have been utilized for the treatment of serious bacterial infections for almost 80 years. There have been approximately 15 members of this class approved worldwide for the treatment of a variety of infections, many serious and life threatening. While aminoglycoside use declined due to the introduction of other antibiotic classes such as cephalosporins, fluoroquinolones, and carbapenems, there has been a resurgence of interest in the class as multidrug-resistant pathogens have spread globally. Furthermore, aminoglycosides are recommended as part of combination therapy for empiric treatment of certain difficult-totreat infections. The development of semisynthetic aminoglycosides designed to overcome common aminoglycoside resistance mechanisms, and the shift to once-daily dosing, has spurred renewed interest in the class. Plazomicin is the first new aminoglycoside to be approved by the FDA in nearly 40 years, marking the successful start of a new campaign to rejuvenate the class. AMINOGLYCOSIDE HISTORY Aminoglycoside antimicrobials were first discovered in the 1940s and originally isolated from actinomycetes. Streptomycin, isolated from Streptomyces griseus, was the first aminoglycoside introduced into clinical practice for the treatment of tuberculosis (1, 2). Selman Waksman (the first to coin the term "antibiotic") won the Nobel Prize in 1952 for the discovery of streptomycin, along with Albert Schatz, who was eventually recognized as a codiscoverer. Since then, a number of aminoglycosides have been discovered as products from the Streptomyces group ("mycin" aminoglycosides, e.g., neomycin, kanamycin, tobramycin) or Micromonospora group ("micin" aminoglycosides, e.g., gentamicin, sisomicin) species, or developed through chemical modifications using existing aminoglycoside scaffolds (e.g., amikacin, netilmicin, arbekacin, plazomicin). Plazomicin is an aminoglycoside that was engineered to overcome aminoglycoside-modifying enzymes (AMEs), the most common aminoglycoside resistance mechanism in Enterobacteriaceae, and is the first aminoglycoside to be approved by the FDA (June 2018) since the approval of amikacin in 1981, marking the beginning of a class rejuvenation.