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Interpretative criteria for the agar diffusion susceptibility test with azithromycin.

A L Barry¹, R N Jones

¹Clinical Microbiology Institute, Tualatin, Oregon 97062.

The Journal of Antimicrobial Chemotherapy

|November 1, 1988

Summary

Azithromycin concentrates in tissues, posing challenges for interpreting minimum inhibitory concentration (MIC) breakpoints. Tentative criteria using 15 microgram discs are proposed for susceptibility and resistance, pending further clinical data.

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Area of Science:

Microbiology
Pharmacology
Clinical Science

Background:

Azithromycin, a macrolide antibiotic (CP-62,993), exhibits significant tissue penetration.
Establishing reliable minimum inhibitory concentration (MIC) breakpoints for tissue-penetrating drugs is complex.
The interpretation of MICs requires consideration of achievable drug concentrations in both blood and tissue.

Purpose of the Study:

To propose tentative criteria for interpreting azithromycin susceptibility testing.
To address the challenge of correlating MICs with tissue concentrations for azithromycin.

Main Methods:

Utilized 15 microgram azithromycin discs for susceptibility testing.
Defined breakpoint zones based on zone diameter (mm) and corresponding MIC (mg/l) values.

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Main Results:

Recommended susceptible breakpoint: zone diameter >= 18 mm (MIC <= 2 mg/l).
Recommended resistant breakpoint: zone diameter <= 13 mm (MIC >= 8 mg/l).

Conclusions:

Proposed tentative interpretive criteria for azithromycin disc diffusion tests.
These breakpoints aim to guide clinical interpretation pending further data on azithromycin's pharmacokinetic profile in various tissues.