Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1977 Apr;11(4):631–637. doi: 10.1128/aac.11.4.631

Susceptibility of Anaerobic Bacteria to Metronidazole, Ornidazole, and Tinidazole and Routine Susceptibility Testing by Standardized Methods

Jürg Wüst 1
PMCID: PMC352041  PMID: 856015

Abstract

A total of 114 strains of anaerobic bacteria were examined for their susceptibility to metronidazole, ornidazole, and tinidazole by measuring the minimum inhibitory concentration (MIC) and minimum bactericidal concentration in different media. All strains, with the exception of the isolates of Propionibacterium acnes, were inhibited by 3.1 μg each and killed by 6.3 μg each of all three nitroimidazole compounds per ml. No significant differences in MIC values were found among metronidazole, ornidazole, and tinidazole. Only minor differences were detected by comparing MIC values obtained in brain heart infusion agar with and without sheep blood, brucella agar, and Mueller-Hinton agar (both containing blood). When the strains were tested by the modified broth-disk method proposed by the Anaerobe Laboratory of the Virginia Polytechnic Institute (VPI), there was good correlation with the MIC values (97.4% agreement for metronidazole and 94.7% for ornidazole and tinidazole). For routine testing, use of a 30-μg-class disk of either nitroimidazole derivative is proposed for the broth-disk method, resulting in a final concentration of 6 μg/ml in the test tubes, a concentration easily attainable in body fluids. In contrast to the broth-disk method, there was very poor correlation between inhibition zone diameters by the standardized VPI agar diffusion test and MIC values.

Full text

PDF
631

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blazevic D. J. Evaluation of the modified broth-disk method for determining antibiotic susceptibilities of anaerobic bacteria. Antimicrob Agents Chemother. 1975 Jun;7(6):721–723. doi: 10.1128/aac.7.6.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Busch D. F., Sutter V. L., Finegold S. M. Activity of combinations of antimicrobial agents against Bacteroides fragilis. J Infect Dis. 1976 Mar;133(3):321–328. doi: 10.1093/infdis/133.3.321. [DOI] [PubMed] [Google Scholar]
  3. Chow A. W., Patten V., Guze L. B. Susceptibility of anaerobic bacteria to metronidazole: relative resistance of non-spore-forming gram-positive baccilli. J Infect Dis. 1975 Feb;131(2):182–185. doi: 10.1093/infdis/131.2.182. [DOI] [PubMed] [Google Scholar]
  4. Dornbusch K., Nord C. E. In vitro effect of metronidazole and tinidazole on anaerobic bacteria. Med Microbiol Immunol. 1974;160(4):265–267. doi: 10.1007/BF02121441. [DOI] [PubMed] [Google Scholar]
  5. Dornbusch K., Nord C. E., Wadström T. Biochemical characterization and in vitro determination of antibiotic susceptibility of clinical isolates of Bacteroides fragilis. Scand J Infect Dis. 1974;6(3):253–258. doi: 10.3109/inf.1974.6.issue-3.08. [DOI] [PubMed] [Google Scholar]
  6. ELEK S. D., HILSON G. R. Combined agar diffusion and replica plating techniques in the study of antibacterial substances. J Clin Pathol. 1954 Feb;7(1):37–44. doi: 10.1136/jcp.7.1.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fass R. J., Prior R. B., Rotilie C. A. Simplified method for antimicrobial susceptibility testing of anaerobic bacteria. Antimicrob Agents Chemother. 1975 Oct;8(4):444–452. doi: 10.1128/aac.8.4.444. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ferguson I. R., Smith L. L. Bacteroides fragilis and nitroimidazoles. J Antimicrob Chemother. 1976 Jun;2(2):220–221. doi: 10.1093/jac/2.2.220. [DOI] [PubMed] [Google Scholar]
  9. Finegold S. M., Bartlett J. G., Chow A. W., Flora D. J., Gorbach S. L., Harder E. J., Tally F. P. Management of anaerobic infections. Ann Intern Med. 1975 Sep;83(3):375–389. doi: 10.7326/0003-4819-83-3-375. [DOI] [PubMed] [Google Scholar]
  10. Gorbach S. L., Bartlett J. G. Anaerobic infections. 1. N Engl J Med. 1974 May 23;290(21):1177–1184. doi: 10.1056/NEJM197405232902106. [DOI] [PubMed] [Google Scholar]
  11. Hamilton-Miller J. M. Antimicrobial agents acting against anaerobes. J Antimicrob Chemother. 1975 Sep;1(3):273–289. doi: 10.1093/jac/1.3.273. [DOI] [PubMed] [Google Scholar]
  12. Inadequate antibody response to HBAg or suppressor T-cell defect in development of active chronic hepatitis. Lancet. 1974 Dec 28;2(7896):1540–1543. [PubMed] [Google Scholar]
  13. Ingham H. R., Rich G. E., Selkon J. B., Hale J. H., Roxby C. M., Betty M. J., Johnson R. W., Uldall P. R. Treatment with metronidazole of three patients with serious infections due to Bacteroides fragilis. J Antimicrob Chemother. 1975 Jun;1(2):235–242. doi: 10.1093/jac/1.2.235. [DOI] [PubMed] [Google Scholar]
  14. Kislak J. W. The susceptibility of Bacteroides fragilis to 24 antibiotics. J Infect Dis. 1972 Mar;125(3):295–299. doi: 10.1093/infdis/125.3.295. [DOI] [PubMed] [Google Scholar]
  15. Laslie W. W., Lambe D. W., Jr Susceptibility testing of anaerobic bacteria with 100-microg carbenicillin disks. Antimicrob Agents Chemother. 1976 Jul;10(1):112–118. doi: 10.1128/aac.10.1.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Martin W. J., Gardner M., Washington J. A., 2nd In vitro antimicrobial susceptibility of anaerobic bacteria isolated from clinical specimens. Antimicrob Agents Chemother. 1972 Feb;1(2):148–158. doi: 10.1128/aac.1.2.148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Metzler C. M., DeHaan R. M. Susceptibility tests of anaerobic bacteria: statistical and clinical considerations. J Infect Dis. 1974 Dec;130(6):588–594. doi: 10.1093/infdis/130.6.588. [DOI] [PubMed] [Google Scholar]
  18. Mitre R. J., Rotheran E. B., Jr Anaerobic septicemia from thrombophlebitis of the internal jugular vein. Successful treatment with metronidazole. JAMA. 1974 Nov 25;230(8):1168–1169. [PubMed] [Google Scholar]
  19. Nastro L. J., Finegold S. M. Bactericidal activity of five antimicrobial agents against Bacteroides fragilis. J Infect Dis. 1972 Jul;126(1):104–107. doi: 10.1093/infdis/126.1.104. [DOI] [PubMed] [Google Scholar]
  20. Overman S., Lambe D. W., Jr, Bennett J. V. Proposed standardized method for testing and interpreting susceptibility of Bacteroides fragilis to tetracycline. Antimicrob Agents Chemother. 1974 Apr;5(4):357–361. doi: 10.1128/aac.5.4.357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Plant C. W., Edwards D. I. Effect of tinidazole, metronidazole and nitrofurazone on nucleic acid synthesis in Clostridium bifermentans. J Antimicrob Chemother. 1976 Jun;2(2):203–209. doi: 10.1093/jac/2.2.203. [DOI] [PubMed] [Google Scholar]
  22. Ralph E. D., Kirby W. M. Unique bactericidal action of metronidazole against Bacteroides fragilis and Clostridium perfringens. Antimicrob Agents Chemother. 1975 Oct;8(4):409–414. doi: 10.1128/aac.8.4.409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Reynolds A. V., Hamilton-Miller J. M., Brumfitt W. A comparison of the in vitro activity of metronidazole, tinidazole, and nimorazole against Gram-negative anaerobic bacilli. J Clin Pathol. 1975 Oct;28(10):775–778. doi: 10.1136/jcp.28.10.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Stalons D. R., Thornsberry C. Broth-dilution method for determining the antibiotic susceptibility of anaerobic bacteria. Antimicrob Agents Chemother. 1975 Jan;7(1):15–21. doi: 10.1128/aac.7.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Staneck J. L., Washington J. A., 2nd Antimicrobial susceptibilities of anaerobic bacteria: recent clinical isolates. Antimicrob Agents Chemother. 1974 Sep;6(3):311–315. doi: 10.1128/aac.6.3.311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sutter V. L., Finegold S. M. Susceptibility of Anaerobic bacteria to carbenicillin, cefoxitin, and related drugs. J Infect Dis. 1975 Apr;131(4):417–422. doi: 10.1093/infdis/131.4.417. [DOI] [PubMed] [Google Scholar]
  27. Tally F. P., Armfield A. Y., Dowell V. R., Jr, Kwok Y. Y., Sutter V. L., Finegold S. M. Susceptibility of Clostridium ramosum to antimicrobial agents. Antimicrob Agents Chemother. 1974 Jun;5(6):589–593. doi: 10.1128/aac.5.6.589. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Tally F. P., Sutter V. L., Finegold S. M. Treatment of anaerobic infections with metronidazole. Antimicrob Agents Chemother. 1975 May;7(5):672–675. doi: 10.1128/aac.7.5.672. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Whelan J. P., Hale J. H. Bactericidal activity of metronidazole against Bacteroides fragilis. J Clin Pathol. 1973 Jun;26(6):393–395. doi: 10.1136/jcp.26.6.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wikins T. D., Holdeman L. V., Abramson I. J., Moore W. E. Standardized single-disc method for antibiotic susceptibility testing of anaerobic bacteria. Antimicrob Agents Chemother. 1972 Jun;1(6):451–459. doi: 10.1128/aac.1.6.451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Wilkins T. D., Chalgren S. L., Jimenez-Ulate F., Drake C. R., Jr, Johnson J. L. Inhibition of Bacteroides fragilis on blood agar plates and reversal of inhibition by added hemin. J Clin Microbiol. 1976 Mar;3(3):359–363. doi: 10.1128/jcm.3.3.359-363.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Wilkins T. D., Thiel T. Modified broth-disk method for testing the antibiotic susceptibility of anaerobic bacteria. Antimicrob Agents Chemother. 1973 Mar;3(3):350–356. doi: 10.1128/aac.3.3.350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Willis A. T., Ferguson I. R., Jones P. H., Phillips K. D., Tearle P. V., Berry R. B., Fiddian R. V., Graham D. F., Harland D. H., Innes D. B. Metronidazole in prevention and treatment of bacteroides infections after appendicectomy. Br Med J. 1976 Feb 7;1(6005):318–321. doi: 10.1136/bmj.1.6005.318. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES