BACKGROUND: Antimicrobial resistance is a growing problem in North American hospitals as well as hospitals worldwide. OBJECTIVES: To assess the antimicrobial susceptibility patterns of commonly used agents against the 20 most common organisms isolated from Canadian hospitals. METHODS: In total, 7881 isolates were obtained between January 1, 2007, and December 31, 2007, from 12 hospitals across Canada as part of the Canadian Ward Surveillance Study (CANWARD 2007). Of these, 6685 isolates (20 most common organisms) obtained from bacteremic, urinary, respiratory and wound specimens underwent antimicrobial susceptibility testing. Susceptibility testing was assessed using the Clinical and Laboratory Standards Institute broth microdilution method. RESULTS: The most active (based upon minimum inhibitory concentration [MIC] data only) agents against methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) were dalbavancin, daptomycin, linezolid, telavancin, tigecycline and vancomycin, with MICs required to inhibit the growth of 90% of organisms (MIC90) of 0.06 μg/mL and 0.06 μg/mL, 0.25 μg/mL and 0.25 μg/mL, 4 μg/mL and 1 μg/mL, 0.25 μg/mL and 0.25 μg/mL, 0.5 μg/mL and 0.25 μg/mL, and 1 μg/mL and 2 μg/mL, respectively. The most active agents against vancomycin-resistant enterococci were daptomycin, linezolid and tigecycline with MIC90s of 2 μg/mL, 4 μg/mL and 0.12 μg/mL, respectively. The most active agents against Escherichia coli were amikacin, cefepime, ertapenem, meropenem, piperacillin-tazobactam and tigecycline with MIC90s of 4 μg/mL, 2 μg/mL, 0.06 μg/mL or less, 0.12 μg/mL or less, 4 μg/mL and 1 μg/mL, respectively. The most active agents against extendedspectrum beta-lactamase-producing E coli were ertapenem, meropenem and tigecycline with MIC90s of 0.12 μg/mL or less, 0.12 μg/mL or less and 1 μg/mL, respectively. The most active agents against Pseudomonas aeruginosa were amikacin, cefepime, meropenem and piperacillin-tazobactam with MIC90s of 32 μg/mL, 32 μg/mL, 8 μg/mL and 64 μg/mL, respectively. The most active agents against Stenotrophomonas maltophilia were tigecycline and trimethoprimsulfamethoxazole and levofloxacin with MIC90s of 8 μg/mL, 8 μg/mL and 8 μg/mL, respectively. The most active agents against Acinetobacter baumannii were amikacin, fluoroquinolones (eg, levofloxacin), meropenem, and tigecycline with MIC90s of 2 μg/mL or less, 1 μg/mL, 4 μg/mL and 2 μg/mL, respectively. CONCLUSIONS: The most active agents versus Gram-positive cocci from Canadian hospitals were vancomycin, linezolid, daptomycin, tigecycline, dalbavancin and telavancin. The most active agents versus Gram-negative bacilli from Canadian hospitals were amikacin, cefepime, ertapenem (not P aeruginosa), meropenem, piperacillintazobactam and tigecycline (not P aeruginosa). Colistin (polymyxin E) was very active against P aeruginosa and A baumannii.