“…1–6 In this regard the aminoglycosides (AGAs), 7–11 are strong candidates for further development because of their widespread availability, innate potency, and the extensive knowledge base covering their mechanism of action 10,12,13 and chemistry. 7,14–16 Together with the deep understanding of the mechanism of resistance, this knowledge base has long informed the structure-based design of new generations of AGAs, 17–24 as exemplified by the recent introduction of the semi-synthetic AGA plazomicin 1 into clinical practice. 25,26 In addition to the many aminoglycoside modifying enzymes (AMEs), 27–30 a second important and growing mechanism of AGA resistance is the modification of G1405 in the drug binding pocket in the decoding A site of the bacterial ribosome by the ribosomal methyl transferases (RMTs).…”