Diffusion of trimethoprim and sulfamethoxazole from susceptibility disks into agar medium.

The standard practice of using a single susceptibility disk for the antimicrobial combination Septra (trimethoprim/sulfamethoxazole) has been further justified by a direct measurement of the diffusion rates of each compound through agar medium. [(14)C]trimethoprim and [(35)S]sulfamethoxazole, singly and in combination, were applied to blank susceptibility disks which were incubated on 4-inch (10.16-cm) agar plates (Mueller-Hinton medium) at 37 C. The migration of each compound from the disk and diffusion through agar were measured with time by determining the radioactivity in concentric zones extending from the origin. The two compounds diffuse with similar rates, maintaining approximately a 1:20 concentration ratio which is approximately the ratio of trimethoprim to sulfamethoxazole observed in plasma during treatment. The diffusion rate is independent of the presence of the other compound; greater than 95% of the radioactivity is transferred from the disk to the agar in 24 h.