Gatifloxacin (AM-1155, CG 5501) susceptibility testing interpretive criteria and quality control guidelines for dilution and disk (5-μg) diffusion methods

Abstract

Gatifloxacin (formerly AM-1155 and CG5501), a new 8-methoxy fluoroquinolone, has an expanded spectrum of activity against Gram-positive cocci and some anaerobic bacteria. This compound was tested against 600 recent clinical strains of rapidly growing aerobic species to establish susceptibility testing interpretive criteria for the reference broth microdilution and standardized disk (5-μg) diffusion methods of the National Committee for Clinical Laboratory Standards (NCCLS). These strains included 285 Enterobacteriaceae (17 species), 165 staphylococci, 49 enterococci, and 101 nonfermentative Gram-negative bacilli. Based on achievable serum levels with projected gatifloxacin dosing regimens, MIC breakpoints of ≤2 μg/mL (≥18 mm) for susceptibility and ≥8 μg/mL (≤14 mm) for resistance were selected. The absolute agreement between tests was 94.3% with no very major false-resistant errors. The quality control ranges (MIC and zone diameters) for the NCCLS recommended strains were determined in a nine-laboratory NCCLS protocol as follows: Escherichia coli ATCC 25922 = 0.008–0.03 μg/mL and 31–37 mm; Enterococcus faecalis ATCC 29212 = 0.12–1 μg/mL; Pseudomonas aeruginosa ATCC 27853 = 0.5–2 μg/ml and 21–27 mm; Staphylococcus aureus ATCC 25923 = 27–33 mm and S. aureus ATCC 29213 = 0.03–0.12 μg/mL. Gatifloxacin appears to be a promising new fluoroquinolone with acceptable susceptibility testing methods for routine clinical laboratory use.