The six species of the Bacteroides fragilis group are potent pathogens and commonly have different susceptibility patterns. We determined the relative annual isolation rate of anaerobic bacteria and the susceptibility of B. fragilis group species isolated during 1987 at two community hospitals. The relative frequencies of isolation of 261 strains were as follows: B. fragilis, 61%; B. thetaiotaomicron, 17%; B. distasonis, 7%; B. vulgatus, 6%; B. ovatus, 5%; and B. uniforms, 4%. A total of 234 recent clinical isolates were tested against cefmetazole, cefotetan, cefoxitin, ceftizoxime, clindamycin, imipenem, and piperacillin by a brucella agar dilution method. Imipenem was the most active agent tested with all but three isolates (two B. vulgatus and one B. distasonis) susceptible to <2 ,ug/ml. Of the cephalosporins tested, cefoxitin, cefotetan, and cefmetazole were relatively equal against B. fragilis, with 93 to 98 % of strains susceptible to 32 ,ug/ml. Ceftizoxime was less active, with an MIC for 90% of strains tested of 128 ,ug/ml and only 75% of isolates susceptible to 32 Fg/ml. Against B. ovatus, B. vulgatus, B. thetaiotaomicron, and B. uniforms, cefoxitin showed a twoto threefoldsuperior activity compared with that of cefotetan and cefmetazole. In general, ceftizoxime was much less active, except against B. distasonis, for which 78% of isolates were susceptible to 32 ,ug/ml compared with 68% for cefoxitin, 19% for cefmetazole, and 16% for cefotetan. Clindamycin and piperacillin showed activity similar to that of cefoxitin, except piperacillin was less active versus B. vulgatus and B. distasonis. We therefore suggest that clinical laboratories determine the species of B. fragilis group isolates as well as perform susceptibility studies on these isolates. Clinicians should be aware that while B. fragilis is the most frequent isolate, 38% of isolates are from other, more resistant B. fragilis group species.