Established antimicrobial susceptibility testing methods with a new twist--points to consider and a glimpse of the future.

The developments seen in these systems allow speculation about future trends in antimicrobial susceptibility testing methods. Microbiology system manufacturers seem to be heeding the call of all industry, for greater automation, enhanced data management capabilities and increased flexibility (see Table 2 below). [table: see text] Cost seems to be less of an issue. This may be due to the decrease in the availability of medical technologists and the need to find systems with better throughput and increased productivity. Increased automation, data management capabilities, and walkaway technology may justify the additional cost of some of these systems. The computer software package provided with these systems is becoming increasingly important with the focus on quality assurance and utilization. Computer generated data analysis gives the microbiologist the tools to educate physicians through the use of selective reporting functions, antibiograms, cost analysis and drug effectiveness comparisons. Each of the four systems is unique and will probably find a niche among the various markets that exist in the United States, European and other specialized markets. The lack of automation in the ALAMAR system may be its selling point in those areas where automation is not affordable, but new ways are being sought for ease of interpretation of results. BIOMIC and CATHRA systems may be more beneficial to those microbiologists who do not want to stop doing traditional Bauer-Kirby or agar dilution methods, but require computer enhancements. ALADIN, may fill a niche to which other walkaway systems have not adapted, but because of its expense, will face more demands than the other three systems covered in this review.