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Journal of Clinical Microbiology, 02 1996, 479-481, Vol 34, No. 2
PC Mehaffey, SD Putnam, MS Barrett and RN Jones
The macrolide-azilide susceptibility testing (agar dilution, disk
diffusion, Etest) criteria for 105 Neisseria gonorrhoeae strains were
evaluated. In addition, the potencies of azithromycin, clarithromycin, and
erythromycin were studied. The most active macrolide-azilide agent was
azithromycin (MIC at which 90% of the isolates are inhibited [MIC90], 0.5
microgram/ml) compared with clarithromycin (MIC90, 1.5 to 2 micrograms/ml)
and erythromycin (MIC90, 2 to 4 micrograms/ml). The Etest (AB Biodisk,
Solna, Sweden) was observed to produce MIC results very similar to those of
the reference agar dilution test (GC agar base), with 100% of the results
within 1 log2 dilution step of the reference MICs. The disk diffusion test
zone diameters for all three drugs correlated at an acceptable level (r =
-0.81 to -0.92) with the reference agar dilution MICs. Interpretive
criteria for susceptibility were proposed for azithromycin at a MIC of <
or = 2 micrograms/ml and a disk diffusion test zone of > or = 25 mm. No
category for resistance was proposed because of the paucity of strains for
which MICs were > 2 micrograms/ml. These tentative criteria should be
further validated by correlations with clinical trial data for gonococcal
strains (as they emerge) that have azithromycin MICs above the proposed
susceptible category range.
Copyright © 1996 by the American Society for Microbiology. All rights reserved.
Evaluation of in vitro spectra of activity of azithromycin, clarithromycin, and erythromycin tested against strains of Neisseria gonorrhoeae by reference agar dilution, disk diffusion, and Etest methods
Medical Microbiology Division, University of Iowa College of Medicine, Iowa City 52242, USA.
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