Abstract
Infectious diseases continue to be a global health burden. Among the major human pathogens is the Gram-negative bacterium Pseudomonas aeruginosa, which is particularly due to its wide range of drug resistance mechanisms. Aminoglycosides, which have long been used in treating pseudomonal infections, are increasingly undermined by resistance. This opinion article discusses the use and challenges of aminoglycosides against P. aeruginosa and highlights recent strategies that enhance aminoglycoside efficacy. These include combinational therapies, metabolic stimulants/adjuvants, silver, and more recently developed derivatives such as AGXX, many of which have been reported to potentiate the cytotoxic effects of aminoglycosides and re-sensitise aminoglycoside-resistant strains. While these findings pave the way for future therapies, the clinical relevance of many in vitro studies remains to be investigated.