There are many different procedures that microbiologists use to study the effects of various antimicrobial agents in treating an infection caused by different microorganisms. Mueller Hinton Agar is considered as best for the routine susceptibility testing since it is has batch-to-batch reproducibility, low concentration of inhibitors of sulphonamide, trimethoprim and tetracyclines and produce satisfactory results for most of the non-fastidious pathogens. Fastidious organisms which require specific growth supplements need different media to grow for studying the susceptibility patterns.
The Kirby Bauer test is a qualitative assay whereby disks of filter paper are impregnated with a single concentration of different antibiotics or any chemicals that will diffuse from the disk into the agar. The selected antibiotic disks are placed on the surface of an agar plate which has already been inoculated with test bacteria. During the incubation period, the antibiotics/chemicals diffuse outward from the disks into the agar. This will create a concentration gradient in the agar which depends on the solubility of the chemical and its molecular size. The absence of growth of the organism around the antibiotic disks indicates that, the respected organism is susceptible to that antibiotic and the presence of growth around the antibiotic disk indicates the organism is resistant to that particular antibiotic. This area of no growth around the disk is known as a zone of inhibition, which is uniformly circular with a confluent lawn of growth in the media.
The diameters of the zone of inhibition are measured (including disk) using a metric scale or a sliding caliper. The measured zone diameter can be compared with a standard chart for obtaining the susceptible and resistant values. There are zone of intermediate resistance which means that the antibiotic may not be sufficient enough to eradicate the organism from the body.