Interpretive standards for disk susceptibility tests with Sch 21420 and amikacin.

Disk susceptibility tests with two structurally related aminoglycosides (amikacin and Sch 21420) were evaluated. Tests with 10- and 30-micrograms amikacin disks confirmed previous recommendations for interpretive zone standards; 30-micrograms disks are preferred. Tests with 10-, 20-, and 30-micrograms Sch 21420 disks led to similar conclusions. The 30-micrograms Sch 21420 disks are recommended, with zone standards of less than or equal to 14 mm for the resistant category (minimal inhibitory concentration, greater than or equal to 32 micrograms/ml) and greater than or equal to 17 mm for the susceptible category (minimal inhibitory concentration, less than or equal to 16 micrograms/ml). If a minimal inhibitory concentration breakpoint of less than or equal to 8 micrograms/ml is preferred for defining the susceptible category, somewhat different zone standards may be used (less than or equal to 15 mm and greater than or equal to 19mm). Further evaluation documented the fact that tests with 30-micrograms amikacin disks predicted resistance or susceptibility to Sch 21420 almost as well as did a 30-micrograms Sch 21420 disk. Thus, the class concept of disk testing was judged to applicable, and routine testing with Sch 21420 may not be required.