Fluconazole disc diffusion testing for the routine laboratory

The increasing incidence of resistance to the antifungal agent, fluconazole, prompted the need for a rapid, reliable and easy-to-use susceptibility test. We have developed a disc diffusion test for fluconazole against Candida spp. suitable for a clinical laboratory. Disc diffusion tests on six different media were compared with MIC values. On the basis of correlation coefficient with MICs (r = -0.95), quality of growth and zone edge definition, Yeast Nitrogen Base agar with glucose (YNBG) produced the best results. Further studies on YNBG showed that the method is reliable for Candida albicans and for resistant isolates with no zone of inhibition, but results for the slower growing and uncommon species must be interpreted with some caution. Implementation of this test in the clinical laboratory has provided a much needed therapeutic service for clinicians within the hospital. It has also reduced the reliance on the reference laboratory for susceptibility results and the consequent costs involved.