Criteria for testing the susceptibility of Streptococcus pneumoniae to cefotaxime and its desacetyl metabolite using 1 microgram or 30 micrograms cefotaxime disks.

In vitro susceptibility tests were performed with 350 selected strains of Streptococcus pneumoniae to evaluate disk diffusion tests with 30 micrograms and 1 microgram cefotaxime disks. Zones were compared to MICs of cefotaxime with and without its desacetyl metabolite. Cefotaxime was two to eight times more active than desacetyl cefotaxime, but the two compounds were additive when combined in vitro. For 30 micrograms disks, zone size breakpoints were < or = 27 mm, 28-30 mm and > or = 31 mm for resistant, intermediate and susceptible, respectively. For 1 microgram disks, those zone size criteria were reduced to < or = 13 mm, 14-16 mm and > or = 17 mm. The 30 micrograms disk that is currently available for testing other species can be used for testing pneumococci; however, the 1 microgram disk has some important advantages.