Plazomicin Sulfate

Plazomicin Sulfate is a broad-spectrum, next-generation aminoglycoside synthetically derived from the natural product sisomicin. The compound was developed by Achaogen to combat multidrug-resistant Enterobacteriaceae, and later a generic version was marketed by Cipla USA. Synthesis involved appending a hydroxy-aminobutyric acid at position 1 and hydroxyethyl at position 6 to sisomicin. The addition of the hydroxyethyl makes it impervious to acetylation by Aminoglycoside Acetyltransferase 6'-N-Type 1b (AAC(6')-1b), the most prevalent AAC enzyme.
Plazomicin Sulfate is soluble in DMSO and slightly soluble in water.

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Background

Aminoglycosides typically bind to the aminoacyl-tRNA site (A-site) of the 30S ribosome bacterial and induce a conformational change to further facilitate the binding between the rRNA and the antibiotic. This leads to codon misreading and mistranslation of mRNA during bacterial protein synthesis.
Plazomicin is not affected by aminoglycoside-modifying enzymes (AMEs) such as acetyltransferases, nucleotidyltransferase and phosphotransferases, with the exception of aminoglycoside acetyltransferase aac(2')-Ia and aminoglycoside acetyltransferase aph(2″)-IVa AMEs are responsible for resistance seen in multi-drug resistant Gram-negative bacilli.
Similarly to other aminoglycosides, Plazomicin is ineffective against bacterial isolates that produce 16S rRNA methyltransferases.