To test antibiotic resistance in Campylobacter spp., the broth microdilution method was used with 5 % sheep blood. For all other pathogens, antimicrobial susceptibilities were determined by the agar dilution method according to the Clinical and Laboratory Standards Institute (CLSI) Guidelines, 2015 [20 ]. All isolates of Salmonella spp. were tested for their minimum inhibitory concentrations (MICs) of ampicillin, ampicillin-sulbactam, ceftriaxone, cefotaxime, nalidixic acid, ciprofloxacin, levofloxacin, co-trimoxazole, azithromycin, chloramphenicol and tetracycline (Oxoid); DEC were tested for ampicillin, ampicillin-sulbactam, cefotaxime, ciprofloxacin, levofloxacin, chloramphenicol, tetracycline, cefazolin, cefuroxime, imipenem, amikacin and gentamicin (Oxoid); Campylobacter spp. were tested for ciprofloxacin, azithromycin, tetracycline, erythromycin and doxycycline (Oxoid); and Aeromonas spp. were tested for cefotaxime, ciprofloxacin, levofloxacin, co-trimoxazole, chloramphenicol, tetracycline, cefazolin, cefuroxime, imipenem, amikacin and gentamicin (Oxoid). ATCC 25922, 35218, 700603 and 27853 were used as quality control strains. Antibiotic susceptibility was interpreted according to CLSI guidelines, 2015 [20 ].
Azithromycin
Manufactured by Thermo Fisher Scientific
Sourced in United Kingdom, United States
Azithromycin is an antibiotic medication used to treat various bacterial infections. It belongs to the macrolide class of antibiotics and works by inhibiting the growth of bacteria.
Automatically generated - may contain errors
Lab products found in correlation
Ciprofloxacin, by Thermo Fisher Scientific (29 mentions)
Ampicillin, by Thermo Fisher Scientific (20 mentions)
Chloramphenicol, by Thermo Fisher Scientific (20 mentions)
Tetracycline, by Thermo Fisher Scientific (19 mentions)
Erythromycin, by Thermo Fisher Scientific (19 mentions)
Gentamicin, by Thermo Fisher Scientific (18 mentions)
Ceftriaxone, by Thermo Fisher Scientific (15 mentions)
Amikacin, by Thermo Fisher Scientific (14 mentions)
Trimethoprim sulfamethoxazole, by Thermo Fisher Scientific (13 mentions)
Cefotaxime, by Thermo Fisher Scientific (12 mentions)
Cefoxitin, by Thermo Fisher Scientific (12 mentions)
Clindamycin, by Thermo Fisher Scientific (11 mentions)
Nalidixic acid, by Thermo Fisher Scientific (10 mentions)
Imipenem, by Thermo Fisher Scientific (10 mentions)
Levofloxacin, by Thermo Fisher Scientific (10 mentions)
Mueller hinton agar (mha), by Merck Group (8 mentions)
Gentamycin, by Thermo Fisher Scientific (8 mentions)
Penicillin, by Thermo Fisher Scientific (7 mentions)
Vancomycin, by Thermo Fisher Scientific (7 mentions)
Ceftazidime, by Thermo Fisher Scientific (7 mentions)
50 protocols using azithromycin
1
Antimicrobial Susceptibility Testing of Pathogens
2
Antimicrobial Susceptibility Testing of Enterobacteriaceae
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Antimicrobial susceptibility testing (AST) was carried out using Kirby Bauer’s Disc Diffusion method and interpreted according to the Clinical and Laboratory Standard Institute (CLSI) guidelines (2018).
The following antibiotics for the Enterobacteriaceae were tested: Ceftriaxone (30μg), Sulfamethoxazole-trimethoprim (25μg), Piperacillin-tazobactam (110 μg), Ticarcillin-clavulanate (85μg), Tetracycline (30μg), Amikacin (30μg), Gentamicin (10μg), Ciprofloxacin (5μg), Meropenem (10μg), Azithromycin (15μg), Chloramphenicol (30μg), Nitrofurantoin (300μg), Nalidixic acid (30μg), Ceftazidime (30μg) and Amoxicillin-clavulanate (30μg) (Oxoid, Basingstoke, Hants, UK). Quality control was ensured by using standard strains (Klebsiella pneumoniae, ATCC 700603 and Escherichia coli, ATCC 25922) in determining susceptibility or otherwise of stool isolates. The definition of multidrug resistance (MDR) was based on the resistance to three or more classes of antimicrobial agents [27 (link)].
The following antibiotics for the Enterobacteriaceae were tested: Ceftriaxone (30μg), Sulfamethoxazole-trimethoprim (25μg), Piperacillin-tazobactam (110 μg), Ticarcillin-clavulanate (85μg), Tetracycline (30μg), Amikacin (30μg), Gentamicin (10μg), Ciprofloxacin (5μg), Meropenem (10μg), Azithromycin (15μg), Chloramphenicol (30μg), Nitrofurantoin (300μg), Nalidixic acid (30μg), Ceftazidime (30μg) and Amoxicillin-clavulanate (30μg) (Oxoid, Basingstoke, Hants, UK). Quality control was ensured by using standard strains (Klebsiella pneumoniae, ATCC 700603 and Escherichia coli, ATCC 25922) in determining susceptibility or otherwise of stool isolates. The definition of multidrug resistance (MDR) was based on the resistance to three or more classes of antimicrobial agents [27 (link)].
3
Antimicrobial Susceptibility of Shigella in Somalia
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The choice of the antibiotics tested in this study was guided by clinical data on drugs used in the management of diarrheal diseases in Banadir Hospital, Somalia. To this end, we tested the antimicrobial susceptibility of Shigella serogroups to six antibiotics: including ampicillin (10 μg), tetracycline (30 μg), trimethoprim-sulfamethoxazole (1.25 μg), ciprofloxacin (30 μg), ceftriaxone (30 μg), and azithromycin (15 μg) (Oxoid, UK) using the Kirby–Bauer disc diffusion method. A bacterium suspension equivalent to 0.5 McFarland standard was prepared and inoculated on Mueller–Hinton agar (Merck, Germany). The plates were allowed to dry for 3–5 minutes, antimicrobial discs were placed on the medium, and subsequently, the culture plates were incubated at 37°C for 24 hours. The minimum inhibition zones were determined and interpreted following the Clinical Laboratory Standards Institute (CLSI, 2018) [11 ] guidelines, and Escherichia coli strain (ATCC 25922) was used as a quality control organism.
4
Antimicrobial Susceptibility Testing via Kirby-Bauer Disk Diffusion
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Antimicrobial susceptibility testing was done using the Kirby-Bauer disk diffusion method on Mueller Hinton agar (Oxoid Ltd.) prepared with 4mm thickness.13
Panels of eleven antimicrobial disks including ampicillin (10µg), amoxicillin-Clavulanic acid (10µg), cefoxitin (30µg), ciprofloxacin (5µg), gentamicin (10µg), norfloxacin (10µg), cefepime (30µg), ceftriaxone (30µg), nitrofurantoin (F) 300µg, amikacin (10µg), and azithromycin (30µg) (Oxoid Ltd.) were used for susceptibility tests. Then, the bacterial isolates were classified as sensitive (S), intermediate (I), or resistance (R) by comparing against the inhibition zone diameter of interpretative standards as indicated in the CLSI guideline.13
Panels of eleven antimicrobial disks including ampicillin (10µg), amoxicillin-Clavulanic acid (10µg), cefoxitin (30µg), ciprofloxacin (5µg), gentamicin (10µg), norfloxacin (10µg), cefepime (30µg), ceftriaxone (30µg), nitrofurantoin (F) 300µg, amikacin (10µg), and azithromycin (30µg) (Oxoid Ltd.) were used for susceptibility tests. Then, the bacterial isolates were classified as sensitive (S), intermediate (I), or resistance (R) by comparing against the inhibition zone diameter of interpretative standards as indicated in the CLSI guideline.13
5
Antimicrobial Resistance Profiling of MRSA
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The pattern of antimicrobial resistance was studied using the simple disk diffusion technique. The Mueller–Hinton agar (Merck, Germany) medium was used for this purpose. Antibiotic resistance of the MRSA strains against 18 commonly used antibiotics was determined using the instructions provided by the Clinical and Laboratory Standards Institute guidelines (18 ). Susceptibility of MRSA isolates was tested against ampicillin (10 µg/disk), gentamycin (10 µg/disk), lincomycin (2 µg/disk), cephalothin (30 µg/disk), imipenem (30 µg/disk), tetracycline (30 µg/disk), vancomycin (5 µg/disk), ciprofloxacin (5 µg/disk), norfloxacin (30 µg/disk), cotrimoxazole (30 µg/disk), clindamycin (2 µg/disk), trimethoprim-sulfamethoxazole (25 μg/disk), penicillin (10 µg/disk), oxacillin (1 µg/disk), erythromycin (15 µg/disk), azithromycin (15 µg/disk), ceftriaxone (30 µg/disk) and cefixime (5 µg/disk) antibiotic agents (Oxoid, UK). The plates containing the discs were allowed to stand for at least 30 minutes before incubation at 35°C for 24 hours. The diameter of the zone of inhibition produced by each antibiotic disc was measured and interpreted using the CLSI zone diameter interpretative standards (18 ). Staphylococcus aureus ATCC 25923 and Escherichia coli (E. coli) ATCC 25922 were used as quality control organisms in antimicrobial susceptibility determination.
6
Antimicrobial Susceptibility Testing of Campylobacters
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Susceptibility to five antimicrobial agents was assessed by the disk diffusion method according to the clinical laboratory and standard institute [41 ] using Mueller-Hinton medium supplemented with 5% defibrinated horse blood (Oxoid, Basingstoke, United Kingdom). The antimicrobials tested included ciprofloxacin 5 µg, erythromycin 15 µg, gentamicin 10 µg, tetracycline 30 µg, and azithromycin 15 µg (Oxoid, Basingstoke, United Kingdom). In the cases when CLSI recommendations were not available for Campylobacters, CLSI guidelines for Enterobacteriaceae were followed. The strains that showed resistance to three or more classes of antimicrobial agents were considered multidrug-resistant (MDR) strains. Reference strains of C. jejuni (NCTC11322) and C. coli (NCTC11366) were used as a control strain.
7
Antibiotic Susceptibility Testing of Salmonella
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All Salmonella isolates were investigated for their in vitro susceptibilities to 13 antibiotics by disk diffusion, as described by Clinical and Laboratory Standard Institute (CLSI) guidelines.20 Disks with the following preparations were used for susceptibility testing: ampicillin (25 μg), chloramphenicol (30 μg), co-trimoxazole (25 μg), tetracycline (25 μg), nalidixic acid (30 μg), ciprofloxacin (20 μg), ofloxacin (20 μg), gentamicin (10 μg), cefotaxime (30 μg), augmentin (30 μg; amoxicillin 20 μg/clavulanic acid 10 μg combination), ceftriaxone (30 μg), ceftazidime (30 μg), imipenem (30 μg), levofloxacin (10 μg), and azithromycin (15 μg) (Oxoid). The plates were incubated aerobically at 37°C for 18–24 hours. The diameter of the zones of inhibition were measured with a ruler and compared with a zone interpretation chart.14 (link)
E. coli American Type Culture Collection (ATCC) 25922 was used as a control. Multidrug resistance phenotype was defined as resistance to three or more classes of antibiotics.
E. coli American Type Culture Collection (ATCC) 25922 was used as a control. Multidrug resistance phenotype was defined as resistance to three or more classes of antibiotics.
8
Antibiotic Resistance Profiling of S. aureus
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The phenotypic pattern of antibiotic resistance of S. aureus bacteria was investigated using the disk diffusion method on Mueller–Hinton agar (Merck, Germany).13 (link) Principles of the Clinical Laboratory Standard Institute (CLSI) were used for this purpose.14 Diverse kinds of antibiotic agents including aminoglycosides (amikacin (30 µg/disk) and gentamicin (10 µg/disk)), fluoroquinolones (levofloxacin (5 µg/disk) and ciprofloxacin (5 µg/disk)), lincosamides (clindamycin (2 µg/disk)), macrolides (erythromycin (15 µg/disk) and azithromycin (15 µg/disk)), penicillins (penicillin (10 µg/disk)), tetracyclines (doxycycline (30 µg/disk) and tetracycline (30 µg/disk)), phenicols (chloramphenicol (30 µg/disk)), folate pathway inhibitors (trimethoprim–sulfamethoxazole (25 µg/disk)), and ansamycins (rifampin (5 µg/disk)) were used for this goal (Oxoid, UK). The method was completed using the protocol characterized previously.14
S. aureus (ATCC 43300 and ATCC 29213) was used as the quality control organism in antimicrobial susceptibility determination.
S. aureus (ATCC 43300 and ATCC 29213) was used as the quality control organism in antimicrobial susceptibility determination.
9
Antimicrobial Susceptibility Testing Protocol
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Antimicrobial susceptibility was determined using the disc diffusion method, in accordance with the Clinical and Laboratory Standard Institute (CLSI) [27 (link)] for the following antibiotics: Ampicillin (AMP, 10 µg), cefoxitin (FOX, 30 µg), cefotaxime (CTX, 30 µg), ciprofloxacin (CIP, 5 µg), norfloxacin (NOR, 10 µg), tobramycin (TOB, 10 µg), gentamicin (GEN, 10 µg), doxycycline (DOX, 5 µg), amikacin (AMK, 30 µg), azithromycin (AZM, 15 µg), nitrofurantoin (NIT, 300 µg), amikacin, vancomycin (VA, 30 µg), linezolid (LZD, 30 µg) and sulfamethoxazole/trimethoprim (SXT, 1.25/23.75 µg) (Oxoid, Hampshire, England). The results were interpreted using the criteria outlined in CLSI guidelines based on the inhibition zone produced, which correlate with susceptibility levels [27 (link)]. The obtained results were used to identify the percentage of MDR among the tested isolates. As previously documented, multidrug resistance (MDR) is defined as resistance to three or more antimicrobial classes [28 (link)]. The phenotypic identification of the isolates as MRSA was performed against cefoxitin through the disk diffusion method, while the standard strain of S. aureus (ATCC 29312) was included as a control isolate.
10
Antibiotic Resistance Profiling of S. epidermidis
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Patterns of antimicrobial resistance of the S. epidermidis strains were studied using the Kirby-Bauer method. A simple disk diffusion technique on the Mueller-Hinton agar (Merck, Germany) medium was used for this purpose. susceptibility of S. epidermidis isolates was tested against several types of antibiotic agents including penicillin (10 μg/disk), cefazolin (30 μg/disk), clindamycin (2 μg/disk), mupirocin (30 μg/disk), azithromycin (15 μg/disk), erythromycin (15 μg/disk), tetracycline (30 μg/disk), ciprofloxacin (5 μg/disk), trimethoprim-sulfamethoxazole (25 μg/disk), nitrofurantoin (300 μg/disk), and rifampin (5 μg/disk) (Oxoid, UK). The instructions of the Clinical and Laboratory Standards Institute were used for this purpose [46 ]. The plates containing the disks were allowed to stand for at least 30 min before incubated at 37 °C for 24 h. The diameter of the zone of inhibition produced by each antibiotic disc was measured and interpreted using the CLSI zone diameter interpretative standards [46 ]. S. epidermidis ATCC 12228 was used as a quality control organism in antimicrobial susceptibility determination.
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