We did not assess the influence of aminoglycoside “mix” (use of which agent predominated at various times) on resistance trends. Reports from the 1980s indicated that predominant use of amikacin at individual institutions

resulted in improved gentamicin and/or tobramycin susceptibility among Gram-negative selleck screening library pathogens without a sacrifice in amikacin susceptibility [19, 20]. Whether the changes in Selleckchem Entospletinib susceptibility we did observe between 1992 and 2012 in our pathogens of interest, none of which were statistically significant, were related to the change from predominant amikacin–gentamicin use to predominant tobramycin use is unknown. Further, whether these non-statistically significant changes were also clinically insignificant is a matter for consideration. Conclusion Low levels of aminoglycoside use, accompanied by stable susceptibility patterns in key Gram-negative pathogens, make these agents viable for treatment of serious infections for which other antibiotics may no longer be suitable. Acknowledgments Dr. John Bosso is the guarantor for this article, and takes responsibility for the integrity of the work as a whole. No funding or sponsorship was received for this study or publication of this article. Conflict of interest John Bosso, Martha L. Haines, and Juanmanuel Gomez declare no conflict of interest. Compliance

YH25448 in vivo with ethical guidelines 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 Cyclooxygenase (COX) or animal subjects performed by any of the authors.

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