* Adapted in part from CLSI document M100-S23 (M02-A11) : Disc diffusion supplemental tables Performance standards for antimicrobial

susceptibility testing.
The complete standard may be obtained from the Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, PA 19807.

Test Cultures (zone diameters in mm)

Antimicrobial Agent

Disc Code

Potency

Amikacin

AK

30 g

AMC

20/10 g

Resistant

Intermediate

Susceptible

EnterobacteriaceaeK, P. aeruginosa,
14

15-16

17

EnterobacteriaceaeE

13

14-17

18

Staphylococcus spp.A,Q

19

20

Haemophilus spp.A,Y

19

20

Enterobacteriaceae and Vibrio cholerae

13

14-16

17

Staphylococcus spp.A,Q

28

Enterococcus spp.A,V,W,k,m

16

17

Haemophilus spp.Y

18

19-21

22

Streptococcus spp. -Hemolytic GroupA,d

24

11

12-14

15

19

20

Group, and S. pneumoniae)

13

14-17

18

Neisseria meningitidis A,i

20

Haemophilus spp.A

12

17

18-20

21

15

16-21

22

26

Enterobacteriaceae

19

20-22

23

Pseudomonas aeruginosaP

13

14-16

17

14

15-17

18

Acinetobacter spp., and Staphylococcus spp.

Amoxycillin - Clavulanic Acid

AmpicillinC,n

AMP
E

10 g

Ampicillin Sulbactam

SAM

10/10 g

EnterobacteriaceaeE, Acinetobacter spp., and Staphylococcus spp.

Haemophilus spp.A,Y
Azithromycin

AZM

29

15 g

Staphylococcus spp., Streptococcus spp Viridans Groupn, -Hemolytic

Aztreonam

ATM

30 g

EnterobacteriaceaeE
P. aeruginosa
Haemophilus spp.A
Carbenicillin

CAR

Cefaclor

CEC

100 g

30 g

Enterobacteriaceae and Staphylococcus spp.

16

17-19

20

14

15-17

18

14
19

15-17
20-22

18
23

Acinetobacter spp., and Staphylococcus spp.

14

15-17

18

Haemophilus spp.A

26

Neisseria gonorrhoeaeA

Streptococcus spp. -Hemolytic GroupA,d

24

Streptococcus spp. Viridans Groupn

21

22-23

24

EnterobacteriaceaeE,H

15

16-18

19

Haemophilus spp.A

21

Neisseria gonorrhoeaeA

31

14

15-17

18

Haemophilus spp.Y
Cefamandole

MA

30 g

EnterobacteriaceaeD,E and Staphylococcus spp.

CefazolinG

KZ

30 g

FEP

30 g

Staphylococcus spp.
Enterobacteriaceae
Cefepime
EnterobacteriaceaeE, P. aeruginosa,

Cefixime

CFM

Cefonicid

CID

5 g

30 g

EnterobacteriaceaeD,E and Staphylococcus spp.

Haemophilus spp.Y
CFP

Cefoperazone

CTX

16

17-19

20

15

16-20

21

75 g

EnterobacteriaceaeE,F,J, P. aeruginosa and Staphylococcus spp.

Cefotaxime

31

30 g

EnterobacteriaceaeE,F,G,J

22

23-25

26

P. aeruginosa, Acinetobacter spp., and Staphylococcus spp.

14

15-22

23

Haemophilus spp.A

26

Neisseria meningitidisA

34

Neisseria gonorrhoeaeA

31

Streptococcus spp. -Hemolytic GroupA,d

24

25

26-27

28

12

13-15

16

19

20-25

26

14

15-17

Streptococcus spp. Viridans Group

Cefotetan

CTT

30 g

FOX

30 g

EnterobacteriaceaeD,E and Staphylococcus spp.

Neisseria gonorrhoeaeZ
Cefoxitin
Enterobacteriaceae

18

S. aureus and S. lugdunensisA,R,S

21

22

Coagulase-negative staphylococciA,R,S (except S.lug.)

24

25

Neisseria gonorrhoeaeZ

23

24-27

28

EnterobacteriaceaeE,G,H and Staphylococcus spp.

17

18-20

21

Haemophilus spp.A

21

Neisseria gonorrhoeaeA

29

14

15-17

18

Cefpodoxime

CPD

Cefprozil

CPR

10 g

30 g

EnterobacteriaceaeE,G,I, Staphylococcus spp., and Haemophilus spp.Y

Ceftazidime

CAZ

30 g

EnterobacteriaceaeE,F,J

17

18-20

21

P. aeruginosa, Acinetobacter spp., and Staphylococcus spp.

14

15-17

18

B. cepacia

17

18-20

21

Haemophilus spp.A

26

31

EnterobacteriaceaeE,F,J,

21

22-24

25

P. aeruginosa and Staphylococcus spp.

14

15-19

20

Haemophilus spp.A

26

Neisseria gonorrhoeae

38

Ceftaroline
Haemophilus spp
Streptococcus spp. -Hemolytic Group, S. Pneumoniae,
Enterobacteriaceae
Staphylococcus spp
Ceftriaxone

19
20

20-22
21-23

30
26
23
24

Neisseria gonorrhoeae

Ceftizoxime

ZOX

30 g

CRO

30 g

EnterobacteriaceaeE,F,G,J

19

20-22

23

P. aeruginosa, Acinetobacter spp., and Staphylococcus spp.

13

14-20

21

Haemophilus spp.A

26

Neisseria meningitidisA

34

Neisseria gonorrhoeae

Streptococcus spp. -Hemolytic GroupA,d

24

Streptococcus spp. Viridans Groupn

24

25-26

27

EnterobacteriaceaeD,E,G, and Staphylococcus spp.

14

15-17

18

Haemophilus spp.Y

16

17-19

20

Neisseria gonorrhoeae

25

26-30

31

14

15-17

18

12

13-17

18

Cefuroxime (parenteral)

CXM

KF

Cephalothin

30 g

30 g

EnterobacteriaceaeD,E,G and Staphylococcus spp.

ChloramphenicolB

35

30 g

Enterobacteriaceae, Staphylococcus spp., Enterococcus spp.,

and Vibrio choleraef
Haemophilus spp.

25

26-28

Neisseria meningitidis

19

20-25

26

Streptococcus pneumoniaeA

20

21

17

18-20

21

cus spp.T, and Enterococcus spp.O

15

16-20

21

Haemophilus spp.A

21

Streptococcus spp. Viridans Groupn and -Hemolytic Group

Ciprofloxacin

CIP

29

5 g

P. aeruginosa, Acinetobacter spp., Staphylococ-

meningitidisi

32

33-34

35

Neisseria gonorrhoeae
EnterobacteriaceaeM,

27
20

28-40
21-30

41
31

Staphylococcus spp.

13

14-17

18

Haemophilus spp.

10

11-12

13

16

17-20

21

14

15-20

21

15

16-18

19

10

11

Neisseria

Clarithromycin

CLR

15 g

Streptococcus spp.e Viridans Groupn, -Hemolytic Group,

and S. pneumoniae
Clindamycin

DA

2 g

Staphylococcus spp.U
Streptococcus spp. Viridans Groupn, -Hemolytic Group,
and S. pneumoniae
Colisting
Pseudomonas

aeruginosaA

CT

10 g

Doripenem
P.aeruginosa
Hemophilus spp.
Doxycycline

DOR

10 g

DO

30 g

15

16-18

19
16

Enterobacteriaceae,

10

11-13

14

Acinetobacter spp.

10-12

13

Staphylococcus spp. and Enterococcus spp.

S.pneumoniae
Ertapenem

12
24

13-15
25-27

16
28

18

19-21

Haemophilus spp.A

22
19

Staphylococcus spp.Q

15

16-18

19

EnterobacteriaceaeJ

ETP

10 g

Test Cultures (zone diameters in mm)

Antimicrobial Agent

Disc Code

Potency

ErythromycinB

15 g

Staphylococcus spp.U and Enterococcus spp.

Resistant

Intermediate

Susceptible

13

14-22

23

Streptococcus spp.e Viridans Groupn, -Hemolytic Group,

and S. pneumoniae
Gentamicin

CN

15

16-20

21

12

13-14

15

13

14-15

16

16

13

14-17

18

13

14-16

17

15

16-18

19

17

20

21
21

10 g

EnterobacteriaceaeK, P. aeruginosa, Acinetobacter spp., and Staphylococcus spp.

Imipenem

IPM

10 g

EnterobacteriaceaeJ, P. aeruginosa, Acinetobacter spp., and Staphylococcus spp.Q

Haemophilus spp.A
K

Kanamycin

30 g

EnterobacteriaceaeK and Staphylococcus spp.

Levofloxacin

LEV

5 g

EnterobacteriaceaeM, P. aeruginosa, S. Maltophilia, Acinetobacter spp.,

Enterococcus spp.O, Streptococcus spp. Viridans Groupn, -Hemolytic
Group, and S. pneumoniae
Staphylococcus spp.T
Haemophilus spp.A
Linezolid

LZD

30 g

Staphylococcus spp.
Streptococcus spp.A Viridans Groupn, -Hemolytic Group and S. pneumoniae

Enterococcus spp.

20

21-22

23

18

19-21

22
22

Lomefloxacin

LOM

10 g

EnterobacteriaceaeM,O, P. aeruginosaO
and Staphylococcus spp.O,T
Haemophilus spp.A

Neisseria gonorrhoeae

26

27-37

38

11

12-14

15

Mecillinam

MEL

10 g

EnterobacteriaceaeE,O
Meropenem

MEM

10 g

EnterobacteriaceaeJ

19

20-22

23

P. aeruginosa, Acinetobacter spp., and Staphylococcus spp.Q

15

16-18

19

B. cepacia

15

16-19

20

Neisseria meningitidis A

30

Haemophilus spp.A

20

17

18-20

21

15

16

12

13-15

16

Mezlocillin

MEZ

75 g

MH

30 g

EnterobacteriaceaeE and Acinetobacter spp.

Pseudomonas

aeruginosaA,P

Minocycline
Enterobacteriaceae, P. aeruginosa and Acinetobacter spp.
Neisseria meningitidisA,i

26

S. maltophilia, B. cepacia, Staphylococcus spp., and Enterococcus spp.

14

15-18

19

Staphylococcus spp.T

20

21-23

24

Streptococcus pneumoniae

14

15-17

18

Haemophilus spp.A

18

10

11-12

13

13

14-18

19

25

26

12

13-14

15

14

15-16

17

12

13-16

17

dans Groupn, -Hemolytic Group, and S. pneumoniae

12

13-15

16

Staphylococcus spp.T

14

15-17

18
16

Moxifloxacin

MFX

Nafcillin

5 g

NF

1 g

NA

30 g

Staphylococcus aureus
Nalidixic Acid
EnterobacteriaceaeM
Neisseria meningitidisj
Netilmicin

NET

30 g

300 g

Enterobacteriaceae , P. aeruginosa and Staphylococcus spp.

K

NitrofurantoinO
Enterobacteriaceae, Staphylococcus spp., and Enterococcus spp.
NorfloxacinO

NOR

10 g

OFX

5 g

EnterobacteriaceaeM P. aeruginosa, Staphylococcus spp.T and Enterococcus spp.

Ofloxacin
EnterobacteriaceaeM,O, P. aeruginosaO, and Streptococcus spp. Viri-

Haemophilus spp.

Neisseria gonorrhoeae

24

25-30

31

10

11-12

13

Oxacillin

OX

1 g

S. aureus R,S

20

Staphylococcus spp.A,Q,R

28

29

Enterococcus spp.A,V,W,k,m

14

15

Neisseria gonorrhoeaea

26

27-46

47

Streptococcus spp. -Hemolytic GroupA,d

24

17

18-20

21

S. pneumoniae (for penicillin susceptibility)A,c

Penicillin

Piperacillin

PRL

10 U

100 g

EnterobacteriaceaeE and Acinetobacter spp.

14

15-20

21

EnterobacteriaceaeE and Acinetobacter spp.

17

18-20

21

Pseudomonas aeruginosaA

14

15-20

21

Staphylococcus spp.A

17

18

Haemophilus spp.A,Y

21

11

12

15

16-18

19

16

17-19

20
25

Pseudomonas aeruginosaA,P
Piperacillin - Tazobactam

TZP

100/10 g

Polymyxin Bg
Pseudomonas aeruginosaA

PB

300 U

Quinupristin Dalfopristinl

QD

15 g

RD

5 g

Staphylococcus spp., Enterococcus spp., and Streptococcus spp Viridans Groupn, -Hemolytic Group, and S. pneumoniae
Rifampinh
Staphylococcus spp., Enterococcus spp., and Haemophilus spp.
Neisseria meningitidisi

19

20-24

Streptococcus pneumoniae

16

17-18

19

14

15-17

18

11

12-14

15

12

13-16

17

10

11-13

14

18

19-21

22

Spectinomycin

SH

100 g

Neisseria gonorrhoeaeZ
Streptomycin

10 g

SFX

300 g

EnterobacteriaceaeK
SulfisoxazoleN
EnterobacteriaceaeO, Staphylococcus spp.O and Vibrio choleraef
Teicoplanin

TEC

30 g

Staphylococcus spp. and Enterococcus spp.

Telithromycin

TEL

15 g

Staphylococcus spp.
Haemophilus spp.

11

12-14

15

Streptococcus pneumoniae

15

16-18

19

11

TetracyclineL

TE

30 g
12-14

15

Staphylococcus spp., Enterococcus spp., and Vibrio choleraef

14

15-18

19

Haemophilus spp.

25

26-28

29

Neisseria gonorrhoeaeb

30

31-37

38

Streptococcus spp. Viridans Groupn, -Hemolytic Group

S. pneumoniae

18
24

19-22
25-27

23
28

Enterobacteriaceae and Acinetobacter spp.

Ticarcillin

TIC

75 g

TIM

75/10 g

14

15-19

20

15

16-23

24

EnterobacteriaceaeE and Acinetobacter spp.

14

15-19

20

Pseudomonas aeruginosaA

15

16-23

Staphylococcus spp.A

22

23

12

13-14

15

10

11-15

16

10

EnterobacteriaceaeE and Acinetobacter spp.

Pseudomonas aeruginosaA,P
Ticarcillin - Clavulanic Acid

Tigecycline

TGC

15g

Tobramycin

TOB

10 g

EnterobacteriaceaeK, P. aeruginosa,

24

Acinetobacter spp., and Staphylococcus spp.

Trimethoprim

5 g

SXT

1.25/23.75 g

Enterobacteriaceae and Staphylococcus spp.

Trimethoprim-Sulfamethoxazole
Enterobacteriaceae, Acinetobacter spp., Staphylococcus spp.,

11-15

16

Neisseria meningitidisi

25

26-29

30

Streptococcus pneumoniae

15

16-18

19

Enterococcus spp.X,m

14

15-16

17

Streptococcus spp.A Viridans Groupe, -Hemolytic Group, and S. pneumoniae

17

Haemophilus spp., Vibrio choleraef, B. cepacia, and S. maltophilia

Vancomycin

VA

30 g

A. For some organism-antimicrobial agent combinations, the absence or rare occurrence of resistant
or intermediate strains precludes defining results categories other than susceptible. For strains yielding results suggestive of a nonsusceptible category, organism identification and antimicrobial susceptibility test results should be confirmed. Subsequently, the isolates should be saved and
submitted to a reference laboratory for confirmation using a CLSI reference dilution method.
B. Not routinely reported on isolates from the urinary tract.
C. Ampicillin is the class representative for ampicillin and amoxycillin.
D. For Salmonella spp. and Shigella spp., first- and second-generation cephalosporins and
cephamycins may appear active in vitro, but are not effective clinically and should not be reported
as susceptible.
E. Before reporting results for Klebsiella spp. and E. coli against penicillins, extended-spectrum
cephalosporins, or aztreonam isolates should be screened for potential ESBL production using an
approved screening method (e.g., current M100-S); however, when using new breakpoints for cefotaxime, ceftazidime, ceftizoxime, ceftriaxone, and aztreonam, routine ESBL testing is no longer
necessary before reporting cephalosporin, penicillin, or aztreonam results.
F. Enterobacter, Citrobacter, and Serratia may develop resistance during prolonged therapy with thirdgeneration cephalosporins. Isolates that are initially susceptible may become resistant within 3 to 4
days after initiation of therapy. Repeat testing may be warranted.
G. For Enterobacteriaceae, cephalothin susceptibility or resistance should be used to predict the results only for cefadroxil, cefpodoxime, cephalexin, and loracarbef. Cefprozil and cefuroxime should
be tested individually. Cefazolin disc diffusion breakpoints have not yet been established to correlate with new cefazolin MIC breakpoints.
H. Cefixime and cefpodoxime disc testing is not applicable to Morganella spp.
I. Cefprozil disc testing is not recommended for Providencia spp. because false-susceptible results
have been reported.
J. Enterobacteriaceae that are resistant to one or more agents in cephalosporin subclass III (i.e., cefoperazone, cefotaxime, ceftazidime, ceftizoxime, and ceftriaxone) and demonstrate reduced disc
zone diameters to carbapenems may produce a carbapenemase. Enterobacteriaceae other than
Proteus, Providencia, and Morganella spp. should be tested for carbapenemase production using
an approved CLSI method (e.g., current M100-S). MICs should be determined for carbapenemaseproducers and the results provided to the clinician and infection control practitioner without interpretation.
K. For Salmonella and Shigella spp., aminoglycosides may appear active in vitro, but are not effective
clinically and should not be reported as susceptible.
L. Organisms that are susceptible to tetracycline can also be considered susceptible to doxycycline and
minocycline. However, some organisms intermediate or resistant to tetracycline may be susceptible to doxycycline or minocycline or both.
M. Fluoroquinolone-susceptible strains of Salmonella that test resistant to nalidixic acid may be associated with clinical failure or delayed response in fluoroquinolone-treated patients with extraintestinal salmonellosis. Extra intestinal isolates of Salmonella should also be tested for resistance to
nalidixic acid.
N. The sulfisoxazole disc can be used to represent any currently available sulfonamide preparations.
O. Indicated for urine isolates only.
P. The susceptible category for carbenicillin, mezlocillin, piperacillin, and ticarcillin implies the need for
high-dose therapy for serious infections caused by P. aeruginosa. Because monotherapy for isolates
of P. aeruginosa has been associated with clinical failure, the addition of a second antimicrobial
agent with in vitro activity against P. aeruginosa should be considered.
Q. Penicillin-susceptible staphylococci can be considered susceptible to other penicillins (i.e., -lactam/-lactamase inhibitor combinations, cephems, and carbapenems). All staphylococci with penicillin zone diameters 29 mm should be tested with an induced -lactamase test before reporting
the isolate as penicillin-susceptible. Because occasional -lactamase-positive staphylococcal isolates are not detected by the induced -lactamase test, laboratories should consider performing an
MIC on isolates from serious infections. All staphylococci which produce -lactamase are penicillinresistant. A positive -lactamase test can be used to predict resistance to penicillin, ampicillin,
amoxycillin, carbenicillin, ticarcillin, mezlocillin, and piperacillin.
R. Penicillin-resistant, oxacillin-susceptible staphylococci can be considered resistant to penicillinaselabile penicillins and susceptible to penicillinase-stable penicillins, -lactam/-lactamase inhibitor
combinations, relevant cephems, and carbapenems.
S. The susceptibility of all staphylococci to oxacillin should be determined using a cefoxitin disc as a
surrogate; report oxacillin results (susceptible or resistant) based on the cefoxitin result. Oxacillinresistant staphylococci are resistant to all currently available -lactam antibiotics. Routine testing of
other penicillins, -lactam/-lactamase inhibitor combinations, cephems, and carbapenems is not
advised. Report oxacillin-resistant staphylococci as resistant to penicillin or do not report.
T. Staphylococcus spp. may develop resistance during prolonged therapy with quinolones. Isolates that
are initially susceptible may become resistant within 3 to 4 days after initiation of therapy. Testing of
repeat isolates may be necessary.

U. Staphylococcus spp. resistant to erythromycin and susceptible or intermediate to clindamycin should

be tested for inducible clindamycin resistance using an approved method (e.g., current M100-S).
V. For enterococci which are non--lactamase-producers, the results of the ampicillin (class representative for ampicillin and amoxycillin) disc test may be used to predict susceptibility to amoxycillinclavulanic acid, ampicillin-sulbactam, piperacillin, and piperacillin-tazobactam. Ampicillin
susceptibility can be used to predict imipenem susceptibility for Enterococcus faecalis, only.2
W.Non--lactamase-producing enterococci which are susceptible to penicillin are predictably susceptible to ampicillin, amoxycillin, ampicillin-sulbactam, amoxycillin-clavulanate, piperacillin, and
piperacillin-tazobactam. However, ampicillin-susceptible enterococci cannot be assumed to be susceptible to penicillin. If penicillin results are needed, the penicillin disc must be tested.2
X. When testing vancomycin against enterococci, plates should be held a full 24 hours for accurate detection of resistance. Zones should be examined using transmitted light; the presence of a haze or
any growth within the zone of inhibition indicates resistance. Organisms with intermediate zones
should be tested by an MIC method approved by CLSI.2
Y. Rare -lactamase-negative, ampicillin-resistant (BLNAR) strains of H. influenzae should be considered resistant to amoxycillin-clavulanate, ampicillin-sulbactam, cefaclor, cefonicid, cefprozil, cefuroxime, and piperacillin-tazobactam despite apparent in vitro susceptibility to these agents.
Z. The clinical effectiveness of treatment for N. gonorrhoeae infection with isolates that are intermediate to cefotetan, cefoxitin, and spectinomycin is unknown.
a. -lactamase-producing strains of N. gonorrhoeae with chromosomally mediated penicillin resistance can be detected only by the disc diffusion method or the agar dilution MIC method.
b. Gonococci with 30 g tetracycline disc zone diameters of 19 mm usually indicate a plasmid-mediated tetracycline-resistant N. gonorrhoeae (TRNG) isolate. Resistance in these strains should be
confirmed by a dilution test.
c. The 1 g oxacillin disc is used to identify strains of S. pneumoniae susceptible ( 20 mm) to penicillin, ampicillin, ampicillin-sulbactam, cefaclor, cefpodoxime, cefprozil, ceftizoxime, cefuroxime,
imipenem, and meropenem. For isolates with oxacillin zones 19 mm, do not report penicillin as
resistant without performing an MIC.
d. The Streptococcus spp. -Hemolytic Group includes the large colony-forming pyogenic strains of
streptococci with Group A, (S. pyogenes), C, or G antigens and strains with Group B (S. agalactiae)
antigen. Small colony-forming -hemolytic strains with Group A, C, F, or G antigens (S. anginosus
group, previously termed S. milleri) are considered part of Streptococcus spp. Viridans Group. For
-hemolytic streptococci (Groups A, B, C, G): an isolate that is susceptible to penicillin can be considered susceptible to ampicillin, amoxycillin, amoxycillin-clavulanic acid, ampicillin-sulbactam, cefazolin, cefepime, cephradine, cephalothin, cefotaxime, ceftriaxone, ceftizoxime, imipenem,
ertapenem, and meropenem. In addition, for group A streptococci only: penicillin susceptibility can
be used to predict susceptibility for cefaclor, cefdinir, cefprozil, ceftibuten, cefuroxime, cefpodoxime,
and cephapirin.2
e. The results of erythromycin disc diffusion test can be used to predict the susceptibility or resistance
of -hemolytic and viridans streptococcal isolates to azithromycin and clarithromycin.
f. For Vibrio cholerae, the results of disc diffusion tests for ampicillin, tetracycline, trimethoprim-sulfamethoxazole, and sulfonamides (i.e., percentage of susceptible, intermediate, and resistant) correlate well with results determined by broth microdilution. When tested against the chloramphenicol
disc diffusion test, V. chloerae has a higher minor error rate which may result in misclassification of
many organisms.2
g. Agents which have a clinical indication for the organism group, but are not generally candidates for
routine testing and reporting in the USA. (colistin, polymyxin B)
h. Rifampin should not be used alone for antimicrobial therapy.
i. May be appropriate only for prophylaxis of meningococcal case contacts. These interpretive criteria do not apply to therapy of patients with invasive meningococcal disease.
j. Nalidixic acid zone size is for surveillance purposes only. A zone of 25 mm may correlate with diminished fluoroquinolone susceptibility.
k. Penicillin or ampicillin resistance due to -lactamase production is not reliably detected with routine
disc or dilution methods but requires a direct, nitrocefin-based -lactamase test. A positive -lactamase test predicts resistance to penicillin, as well as amino- and ureideopenicillins.2
l. For reporting against vancomycin-resistant Enterococcus faecium, methicillin-susceptible Staphylococcus aureus, and Streptococcus pyogenes.
m. Combination therapy of ampicillin, penicillin, or vancomycin (for susceptible strains), plus an aminoglycoside, is usually indicated for serious enterococcal infections, unless high-level resistance to
both gentamicin and streptomycin is documented; such combinations are predicted to result in synergistic killing of Enterococcus spp.2
n. The Streptococcus spp. Viridans Group includes the following five groups, with several species
within each group: mutans group, salivarius group, bovis group, anginosus group (previously S. milleri group), and mitis group. The anginosus group includes small colony-forming -hemolytic strains
with groups A, C, F, and G antigens. Penicillin and ampicillin disc diffusion testing is not reliable with
the Streptococcus spp. Viridans Group. 2

Quality Control Organisms (zone diameters in mm)

Antimicrobial Agent

Potency

Amikacin
Amoxycillin - clavulanic acid
AmpicillinC
Ampicillin Sulbactam
Azithromycin
Aztreonam
Carbenicillin
Cefaclor
Cefamandole
Cefazolin
Cefepime
Cefixime
Cefonicid
Cefoperazone
Cefotaxime
Cefotetan
Cefoxitin
Cefpodoxime
Cefprozil
Ceftaroline
Ceftazidime
Ceftizoxime
Ceftriaxone
Cefuroxime (parenteral)
Cephalothin
ChloramphenicolB
Ciprofloxacin
Clarithromycin
Clindamycin
Colisting
Doripenem
DoxycyclineL
Ertapenem
Erythromycin
Gentamicin
Imipenem
Kanamycin
Levofloxacin
Linezolid
Lomefloxacin
Mecillinam
Meropenem
Mezlocillin
MinocyclineL
Moxifloxacin
Nafcillin
Nalidixic Acid
Netilmicin
Nitrofurantoin
NorfloxacinO
Ofloxacin
Oxacillin
Penicillin
Piperacillin
Piperacillin - Tazobactam
Polymyxin Bg
Quinupristin Dalfopristin
Rifampinh
Spectinomycin
Streptomycin
SulfisoxazoleN
Teicoplanin
Telithromycin
TetracyclineL
Ticarcillin
Ticarcillin - Clavulanic Acid
Tigecycline
Tobramycin
Trimethoprim O
Trimethoprim-Sulfamethoxazole
Vancomycin

30 g
20/10 g
10 g
10/10 g
15 g
30 g
100 g
30 g
30 g
30 g
30 g
5 g
30 g
75 g
30 g
30 g
30 g
10 g
30 g
30 g
30 g
30 g
30 g
30 g
30 g
30 g
5 g
15 g
2 g
10 g
10 g
30 g
10 g
15 g
10 g
10 g
30 g
5 g
30 g
10 g
10 g
10 g
75 g
30 g
5 g
1 g
30 g
30 g
300 g
10 g
5 g
1 g
10 U
100 g
100/10 g
300 U
15 g
5 g
100 g
10 g
300 g
30 g
15 g
30 g
75 g
75/10 g
15 g
10 g
5 g
1.25/23.75 g
30 g

E. coli
ATCC
25922
19-26
18-24
16-22
19-24

28-36
23-29
23-27
26-32
21-27
31-37
23-27
25-29
28-34
29-35
28-34
23-29
23-28
21-27
26-34
25-32
30-36
29-35
20-26
15-21
21-27
30-40

11-17
27-35
18-24
29-36

19-26
26-32
17-25
29-37

27-33
24-30
28-34
23-29
19-25
28-35

22-28
22-30
20-25
28-35
29-33

24-30
24-30
13-19

8-10

12-20
15-23

18-25
24-30
24-30
20-27
18-26
21-28
23-29

S. aureus
ATCC
25923
20-26
28-36
27-35
29-37
21-26

27-31
26-34
29-35
23-29

22-28
24-33
25-31
17-23
23-29
19-25
27-33
26-35
16-20
27-35
22-28
27-35
29-37
19-26
22-30
26-32
24-30

33-42
23-29
24-31
22-30
19-27

19-26
25-30
25-32
23-29

29-37

25-30
28-35
16-22

22-31
18-22
17-28
24-28
18-24
26-37

27-36

21-28
26-34

14-22
24-34
15-21
24-30
24-30

29-37
20-25
19-29
19-26
24-32
17-21

P. aerug.
ATCC
27853
18-26

23-29
18-24

24-30

23-29
18-22

E. coli
ATCC
35218

17-22
6
13-19

22-29
12-17
17-23

25-33

11-17
28-35

13-21

17-23
20-28

19-26

22-28

27-33
19-25

17-25

17-23

22-29
17-21

25-33
25-33
14-18

21-27
20-28
9-13
20-26

21-31

20-28

12-18
24-30

6
21-25
23-31

H. influ.
ATCC
49247

15-23
13-21
14-22
13-21
30-38

25-31
25-33

31-39

25-31

29-39
27-35
29-39
31-39

31-40
34-42
11-17

27-33

21-29

32-40

33-41

20-28

31-39

31-40

33-38

15-21
22-30

17-23
14-22

H. influ.
ATCC
49766

25-31

30-38

20-27

N. gon.
ATCC
49226

37-46
37-45

38-48
30-36
33-41
35-43

28-36

24-32

35-43
42-51
39-51
33-41

48-58

45-54

43-51

26-34

23-29

30-42

30-40

S. pneumo.
ATCCp
49619

30-36

19-25

24-32

28-35
16-23

31-39

28-34
25-32
31-41

28-34
30-35

26-32
23-27

25-31
19-25

30-38

28-35
25-30

20-25
25-34

28-35

25-31

23-29
15-21
16-21
12q
24-30

19-24
25-30

27-33
27-31

23-29

20-28
20-27

The FDA susceptibility test interpretive criteria are derived from the antibacterial drug products labeling at the time of the original new drug application (NDA) approval or a subsequent update.

Test Cultures

(zone diameters in mm)

Antimicrobial Agent
Amikacin
Amoxycillin - Clavulanic Acid
Staphylococcus spp. & Haemophilus influenzae
Other organisms exc. Streptococcus pneumoniae & Neisseria gonorrhoeae
Ampicillin - Sulbactam
Gram-negative & Staphylococcus spp.
Haemophilus influenzae
Azithromycin
Haemophilus spp.
Staphylococcus aureus
Streptococcus spp. incl. Streptococcus pneumoniae
Aztreonam
Aerobic organisms other than Haemophilus influenzae
Haemophilus influenzae
Bacitracin
Staphylococcus aureus
Carbenicillin
Enterobacter spp.
Pseudomonas spp.
Cefaclor
Organisms other than Haemophilus spp. & Streptococcus spp.
Cefazolin
Cefepime
Organisms other than Haemophilus spp. & Strep pneumoniae
Haemophilus spp.
Cefixime
Neisseria gonorrhoeae
All other organisms
Cefoperazone

Disc Code

Potency

Resistant

Intermediate

Susceptible

AK
AMC

30 g
20/10 g

14

15-16

17

19
13

14-17

20
18

SAM

10/10 g
15 g

11
19

12-13
-

AZM

14
20

13
13

14-17
14-17

12
18
18

15
-

16-21
-

22
26

ATM

30 g

10 U

CAR

100 g

CEC

30 g

KZ

30 g

FEP

30 g

CFM

5 g

CFP

75 g

Cefotaxime
Neisseria gonorrhoeae
Haemophilus spp.
Streptococcus spp. other than S. pneumoniae
Organisms other than Haemophilus, N. gonorrhoeae, Streptococcus
Cefotetan

CTX

30 g

CTT

30 g

Cefoxitin
Neisseria gonorrhoeae
Aerobic organisms other than N. gonorrhoeae
Cefpodoxime
Enterobacteriaceae & Staphylococcus spp.
Haemophilus spp.
Neisseria gonorrhoeae
Cefprozil

FOX

30 g

Ceftazidime
Ceftizoxime
Haemophilus spp.
Neisseria gonorrhoeae
Organisms other than Haemophilus spp. & N. gonorrhoeae
Ceftriaxone
Haemophilus spp.
Neisseria gonorrhoeae
Organisms other than Haemophilus spp., N. gonorrhoeae, & Strep spp.
Cefuroxime (parenteral)
Cephalothin
Chloramphenicol
Salmonella spp.
Haemophilus influenzae
Ciprofloxacin
Enterobacteriaceae, Enterococcus faecalis, Staphylococcus spp.,
S. pneumoniae, S. pyogenes, & P. aeruginosa
H. influenzae & H. parainfluenzae
Clarithromycin
Staphylococcus spp.
Streptococcus spp. including S. pneumoniae
Haemophilus spp.
Clindamycin

CPD

10 g

CPR

30 g

CAZ

30 g

ZOX

CRO

30 g

30 g

CXM

30 g

KF

30 g

C
CIP

CLR

30 g
5 g

15 g

DA

2 g

Doripenem
Enterobacteriaceae
P. aeruginosa
Acinetobacter baumannii
Streptococcus anginosus group
Doxycycline

DOR

10 g

DO

30 g

Ertapenem
Enterobacteriaceae & Staphylococcus spp.
Haemophilus spp.
Streptococcus spp. including Streptococcus pneumoniae
Erythromycin

ETP

10 g

15 g

Gentamicin

CN

10 g

Imipenem

IPM

Kanamycin

Levofloxacin
Enterobacteriaceae, E. faecalis, Staphylococcus spp. (methicillin-susceptible), P. aeruginosa, S. pneumoniae, & S. pyogenes
H. influenzae & H. parainfluenzae
Linezolid
Enterococcus spp.
Staphylococcus spp.
Streptococcus spp. including S. pneumoniae
Lomefloxacin

LEV

LZD

10 g
30 g
5 g

30 g

LOM

10 g

Meropenem
Enterobacteriaceae, Acinetobacter spp. & P. aeruginosa
Haemophilus influenzae
Staph aureus
Minocycline

MEM

10 g

MH

30 g

Moxifloxacin
Enterobacteriaceae & Staph aureus (methicillin-susceptible)
H. influenzae & H. parainfluenzae
Streptococcus spp. including S. pneumoniae & E. faecalis
Nafcillin

MFX

5 g

Nalidixic Acid
Neomycin

NF

1 g

NA

30 g

Nitrofurantoin

Norfloxacin

NOR

30 g
300 g
10 g
5 g

Ofloxacin
Enterobacteriaceae, P. aeruginosa, & S.aureus ( methicillin-susceptible)
Haemophilus influenzae
Neisseria gonorrhoeae
Streptococcus pneumoniae & Streptococcus pyogenes
Oxacillin
Staphylococcus aureus
Coagulase-negative Staphylococcus spp.
Penicillin
Staphylococcus spp.
Neisseria gonorrhoeae
Beta-hemolytic streptococci
Piperacillin
Enterobacteriaceae & Acinetobacter spp.
Pseudomonas aeruginosa
Enterococcus faecalis
Haemophilus spp.
Piperacillin - Tazobactam
Enterobacteriaceae & Acinetobacter baumanii
Pseudomonas aeruginosa
Staphylococcus aureus
Polymyxin B

OFX

PB

300 U

Quinupristin Dalfopristin
Enterococcus faecium, Staphylococcus spp., & Streptococcus spp.
(excluding S. pneumoniae)
Rifampin
Neisseria meningitidis
Streptomycin

QD

15 g

Sulfisoxazole

OX

1 g

10 U

PRL

TZP

100 g

100/10 g

RD

5 g

10 g

SFX

300 g
15 g

Telithromycin
Streptococcus pneumoniae
Haemophilus influenzae
Tetracycline

TEL
TE

30 g

Ticarcillin
Pseudomonas aeruginosa & Enterobacteriaceae
Ticarcillin - Clavulanic Acid
Staphylococcus spp.
Enterobacteriaceae
Pseudomonas aeruginosa
Tigecycline
Enterobacteriaceae
Staphylococcus aureus, Streptococcus spp. (including S. pneumoniae), Enterococcus faecalis, & Haemophilus influenzae
Tobramycin

TIC

75 g

Trimethoprim
Enterobacteriaceae & Staphylococcus spp.
Trimethoprim-Sulfamethoxazole
Enterobacteriaceae & Haemophilus influenzae
Streptococcus pneumoniae
Vancomycin
Staphylococcus spp.
Streptococcus spp. (not including S. pneumoniae)
Enterococcus spp.

TIM

TGC

75/10 g

15 g

TOB

10 g

5 g

SXT
VA

1.25 / 23.75 g
30 g

>13

17
13

18-22
14-16

23
17

14

15-17

18

14

15-17

18

14
-

15-17
-

18
26

15

16-18

31
19

15

16-20

21

25
14

26-27
15-22

31
26
28
23

12

13-15

16

23
14

24-27
15-17

28
18

17
-

18-20
-

21
21
29

14

15-17

18

14

15-17

18

14

15-19

26
38
20

13

14-20

26
35
21

14

15-22

23

14

15-17

18

12
25

13-17
26-28

18
29

15

16-20

21

21

13
16
10

14-17
17-20
11-12

18
21
13

14

15-16

17

23
24
17
24

12

13-15

16

15
-

16-18
-

19
19
19

13

14-22

23

12

13-14

15

13

14-15

16

14

15-17

18

13

14-16

17

17

20
-

21-22
-

23
21
21

18

19-21

22

13
13

14-15
14-15

16
20
16

14

15-18

19

15
14

16-18
15-17

19
18
18

10

11-12

13

13

14-18

19

13

14-15

16

14

15-16

17

12

13-16

17

12

13-15

16

24
12

25-30
13-15

16
31
16

10
17

11-12
-

13
18

28
26
-

27-46
-

29
47
24

17
17
14
28

18-20
-

21
18
15
29

17
17
19

18-20
-

21
18
20

>11

15

16-18

19

16

17-19

20

10

11-12

15

12

13-16

17

15
11

16-18
12-14

19
15

19

11

12-14

15

22
14
14

15-19
-

23
20
15

14
-

15-18
-

19
19

12

13-14

15

10

11-15

16

10
15

11-15
16-18

16
19

14

15-16

15
17
17

Data Source
DailyMed: Bristol-Myers Squibb Co., 01/2001
DailyMed: Sandoz Inc., 09/2009

DailyMed: Baxter Healthcare Corp., 05/2009

DailyMed: Pfizer Inc., 01/2009

DailyMed: Bristol-Meyers Squibb, 07/2007

DailyMed: Pharmacia & Upjohn, 09/2006
DailyMed: Roerig, 05/2007
DailyMed: Ranbaxy Pharma. Inc., 05/2007
DailyMed: GlaxoSmithKline, 04/2005
DailyMed: Baxter Healthcare Corp., 01/2010
Lupin Pharmaceuticals, Inc., 10/2008
DailyMed: Roerig (Division of Pfizer), 01/2006
DailyMed: Pfizer Laboratories, 12/2009

DailyMed: AstraZeneca Pharma., LP, 01/2004

DailyMed: Merck & Co., Inc., 10/2006
DailyMed: Sandoz Inc., 09/2008

DailyMed: Sandoz Inc., 01/2008

DailyMed: GlaxoSmithKline LLC, 04/2007
DailyMed: Astellas Pharma US, Inc., No revision date.

DailyMed: Pfizer Laboratories, 07/2009

DailyMed: GlaxoSmithKline LLC, 12/2005

DailyMed: Ranbaxy Pharma. Inc., 01/2007
DailyMed: Monarch Pharma., Inc., 04/2007
DailyMed: Pfizer Labs, 09/2009

DailyMed: Sandoz Inc., 09/2008

DailyMed: Bedford Labs., 07/2008

DailyMed: Ortho-McNeil-Janssen Pharm., Inc., 10/2008

DailyMed: Pfizer Laboratories, 02/2010

DailyMed: Merck Sharp & Dohme Corp., 03/2010

DailyMed: Abbott Laboratories, no revision date

B.Braun Medical Inc. 03/2007
DailyMed: Merck & Co., Inc., 12/2007
DailyMed: Bristol-Myers Squibb Co., no revision date
DailyMed: Hikma Farmaceutica (Portugal), S.A., 07/2009

DailyMed: Pharmacia & Upjohn Co., 12/2009

DailyMed: G.D. Searle LLC, no revision date

DailyMed: AstraZeneca Pharm. LP, 11/2007

DailyMed: Ranbaxy Pharma. Inc., 04/2007

DailyMed: Shering Plough Corp., 10/2008

DailyMed: Baxter Healthcare Corp., 02/2007

DailyMed: Sanofi-Aventis U.S. LLC, 09/2008
Dailymed TEVA pharma USA 03/2007
DailyMed: Procter & Gamble Pharma., 01/2009
DailyMed: Merck Sharp & Dohme Corp., 02/2010
DailyMed: Teva Pharma. USA, 01/2008

DailyMed: Baxter Healthcare Corp., 02/2007

DailyMed: Baxter Healthcare Corp., 02/2008

DailyMed: Wyeth Pharma. Inc., 03/2007

DailyMed: Wyeth Pharma. Inc., 09/2009

DailyMed: Bedford Laboratories, 02/2004

DSM Pharma, Inc., 07/2003
DailyMed: Lannett Company, Inc., 10/2007
Roerig (Division of Pfizer), 08/2006
DailyMed: Roche Laboratories Inc., 11/1997
DailyMed: Sanofi-Aventis U.S. LLC, 06/2009
DailyMed: Blenheim Pharmacal, Inc., 06/2009
GlaxoSmithKline, 09/2002
DailyMed: GlaxoSmithKline LLC, 02/2009

DailyMed: Wyeth Pharmaceuticals Inc., 07/2010

DailyMed: Akorn-Strides, LLC, 08/2007

DailyMed: Watson Laboratories, Inc., 06/2006
DailyMed: Blenheim Pharmacal, Inc., 08/2008
DailyMed: Baxter Healthcare Corp., 02/2009

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trademarks of ATCC. Oxoid Ltd is licensed to use these trademarks and sell products derived from ATCC cultures.

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