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“Introduction In the 1970s and 1980s, the aminoglycoside antibiotics were a key antibiotic group in the treatment of serious Gram-negative infections. With the introduction of new beta-lactam agents with pronounced Gram-negative activity during the 1980s, the use of aminoglycosides waned as the less toxic beta-lactams were increasingly see more used, and this trend continued into the early part of this century [1, 2]. The declining use of one or more of the aminoglycosides was frequently accompanied by observations of increasing susceptibility among key pathogens [3, 4] Depsipeptide price although this relationship has not held true in all studies [2]. We are now entering a time in which we are encountering rapidly increasing Gram-negative resistance to broad-spectrum beta-lactams including third and fourth generation cephalosporins, beta-lactam—beta-lactamase inhibitor combinations, and the carbapenems. This rising resistance is often mediated by extended-spectrum beta-lactamases (ESBL) and carbapenemases [5–7]. Moreover, the Gram-negative pathogens producing these enzymes are often

co-resistant to other important antibiotic classes such as the fluoroquinolones [7–9]. Because of this, it has been suggested by a number of studies that the use of aminoglycosides may be increasing as clinicians search for viable alternative therapies in treating infections with otherwise resistant Gram-negative pathogens [10–12]. The purpose of the present analysis was to assess the level of aminoglycoside use in adults at our institution from 2006 through 2012 and, during that same time period, the level of susceptibility of key Gram-negative pathogens to this antibiotic class.

Non-specific serine/threonine protein kinase Methods This study was conducted at the Medical University of South Carolina Medical Center, a 709-bed academic medical center located in Charleston, South Carolina, USA. The study was approved by the Medical University of South Carolina Medical Center Institutional Review Board. This article does not contain any studies with human or animal subjects performed by any of the authors. Pertinent data were assembled and analyzed for the period 2006 through 2012. Susceptibility data for the years 1992, 2006, and 2008 through 2012 for Pseudomonas aeruginosa, Escherichia coli (non-urine isolates only), and Klebsiella pneumoniae were obtained from the hospital’s annual antibiograms which are produced in accordance with Clinical and Laboratory Standards Institute (CLSI) guidance [13]. Thus, no duplicate or surveillance isolates are included. Susceptibility was determined by an automated system (MicroScan WalkAway®, Siemens Medical Solutions USA, Inc.