Use of the microbial growth curve in postantibiotic effect studies of Legionella pneumophila.

Using the standard Craig and Gudmundsson method (W. A. Craig and S. Gudmundsson, p. 296-329, in V. Lorian, ed., Antibiotics in Laboratory Medicine, 1996) as a guideline for determination of postantibiotic effects (PAE), we studied a large series of growth curves for two strains of Legionella pneumophila. We found that the intensity of the PAE was best determined by using a statistically fitted line over hours 3 to 9 following antibiotic removal. We further determined the PAE duration by using a series of observations of the assay interval from hours 3 to 24. We determined that inoculum reduction was not necessarily the only predictor of the PAE but that the PAE was subject to the type and dose of the drug used in the study. In addition, there was a variation between strains. Only levofloxacin at five and ten times the minimum inhibitory concentration (MIC) resulted in a PAE duration of 4 to 10 h for both strains of L. pneumophila tested. Ciprofloxacin at five and ten times the MIC and azithromycin at ten times the MIC caused a PAE for one strain only. No PAE could be demonstrated for either strain with erythromycin or doxycycline. Using the presently described method of measuring PAE for L. pneumophila, we were able to detect differences in PAE which were dependent upon the L. pneumophila strain, the antibiotic tested, and the antibiotic concentration. We suggest the use of mathematically fitted curves for comparison of bacterial growth in order to measure PAE for L. pneumophila.