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.