Antifungal susceptibility testing using the E test: comparison with the broth macrodilution technique

J Antimicrob Chemother. 1996 Feb;37(2):265-73. doi: 10.1093/jac/37.2.265.


The National Committee for Clinical Laboratory Standards reference broth macrodilution method for antifungal susceptibility testing was compared with the E test by testing 86 clinical isolates of Candida spp. and Cryptococcus neoformans. The MIC agreement rates for the two methods for Candida spp. were 73-89% within +/-1 doubling dilution and 87-100% within +/-2 dilutions. For C. neoformans, agreement within +/-1 dilution was > 70% for all the agents tested except fluconazole for which agreement was 35%. Our data support the further evaluation of the E test as an alternative method for antifungal susceptibility testing. However, E test MICs of fluconazole for C. neoformans, particularly C. neoformans var. gattii should be interpreted with caution, as falsely elevated MICs may occur.

Publication types

  • Comparative Study

MeSH terms

  • Antifungal Agents / pharmacology*
  • Candida / drug effects*
  • Cryptococcus neoformans / drug effects*
  • Culture Media
  • Fluconazole / pharmacology
  • Itraconazole / pharmacology
  • Ketoconazole / pharmacology
  • Microbial Sensitivity Tests / methods*
  • Reproducibility of Results


  • Antifungal Agents
  • Culture Media
  • Itraconazole
  • Fluconazole
  • Ketoconazole