Apramycin is an aminoglycoside antibioticum and has a bactericidal action against many gram-negative bac-teri-a. Apramycin is a structurally unique antibioticum that contains a bicyclic sugar moiety and a monosubstituted deoxystreptamine. Apramycin can only be acetylated by AAC-(3)IV and as a consequence of this enzymatic modification, the antibioticum is unable to enter the cell to bind to its ribosomal target.