Antibiotic kinases, which include aminoglycoside and macrolide phosphotransferases (APHs and MPHs), pose a serious threat to currently used antimicrobial therapies. These enzymes show structural and functional homology with Ser/Thr/Tyr kinases, which is suggestive of a common ancestor. Surprisingly, recent in vitro studies using purified antibiotic kinase enzymes have revealed that a number are able to utilize GTP as the antibiotic phospho donor, either preferentially or exclusively compared to ATP, the canonical phosphate donor in most biochemical reactions. To further explore this phenomenon, we examined three enzymes, APH(3)-IIIa, APH(2؆)-Ib, and MPH(2)-I, using a competitive assay that mimics in vivo nucleotide triphosphate (NTP) concentrations and usage by each enzyme. Downstream analysis of reaction products by high-performance liquid chromatography enabled the determination of partitioning of phosphate flux from NTP donors to antibiotics. Using this ratio along with support from kinetic analysis and inhibitor studies, we find that under physiologic concentrations of NTPs, APH(3)-IIIa exclusively uses ATP, MPH(2)-I exclusively uses GTP, and APH(2؆)-Ib is able to use both species with a preference for GTP. These differences reveal likely different pathways in antibiotic resistance enzyme evolution and can be exploited in selective inhibitor design to counteract resistance.Antibiotic modification is a major mechanism of resistance that impacts the efficacy of numerous antimicrobial drug classes. The enzymes that catalyze these group transfer mechanisms have evolved from precursor genes that encode proteins used to accomplish numerous metabolic tasks no doubt unrelated to drug resistance. Borrowing nomenclature from the oncogene field, we term such elements protoresistance genes. Biochemical and structural evidence has shown that protoresistance genes can be found in a number of key metabolic pathways, including cell wall biosynthesis and signal transduction (23). With respect to group transfer antibiotic resistance enzymes, these protoresistance genes encode protein and other small-molecule kinases, acetyltransferases, adenylyltransferases, ADP-ribosyltransferases, and glycosyltransferases. The addition of phosphoryl, acyl, adenyl, ribosyl, and glycosyl groups to the antibiotic scaffold alters the interaction with the cellular target to such a degree that the resistance phenotype results (6).The unifying biochemical logic of group transfer in antibiotic resistance is the co-opting of the normal cellular function of the protoresistance element by natural selection to include the modification of antibiotic molecules. Because group transfer enzymes require a second substrate (e.g., ATP, acetyl coenzyme A, or thymidine diphosphate glucose), these should retain the original specificity of the protoresistance enzyme since natural selection would not normally be expected to act on this site during resistance gene evolution.Antibiotic kinases represent a large superfamily of enzymes that covalently modify antibiotic...