Journal article
Days of Antibiotic Spectrum Coverage (DASC): A Novel Metric for Inpatient Antibiotic Consumption
Clinical infectious diseases, Vol.75(4), pp.567-576
08/15/2022
DOI: 10.1093/cid/ciab1034
PMID: 34910130
Abstract
Abstract Background Days of Therapy (DOT), the most widely used benchmarking metric for antibiotic consumption, may not fully measure stewardship efforts to promote use of narrow-spectrum agents and may inadvertently discourage the use of combination regimens when single-agent alternatives have greater adverse effects. To overcome DOT’s limitations, we developed a novel metric, Days of Antibiotic Spectrum Coverage (DASC), and compared hospitals’ performances using this novel metric with DOT. Methods We evaluated 77 antibiotics in 16 categories of antibacterial activity to develop our spectrum scoring system. DASC was then calculated as cumulative daily spectrum scores. To compare hospital benchmarking using DOT and DASC, we conducted a retrospective cohort study of adult patients admitted to acute care units within the Veterans Health Administration system in 2018. Antibiotic administration data were aggregated to calculate each hospital’s DOT and DASC per 1,000 days present (DP) for ranking. Results The spectrum score for each antibiotic ranged from 2 to 15. There was little correlation between DOT per 1,000 DP and DASC per DOT, indicating that lower antibiotic consumption at a hospital does not necessarily mean more frequent use of narrow-spectrum antibiotics. The differences in each hospital’s ranking between DOT and DASC per 1,000 DP ranged from -29.0% to 25.0%, respectively, with 27 (21.8%) hospitals having differences >10%. Conclusions We propose a novel composite metric for antibiotic stewardship, DASC, that combines consumption and spectrum as a potential replacement for DOT. Further studies are needed to evaluate whether benchmarking using the DASC will improve evaluations of stewardship.
Details
- Title: Subtitle
- Days of Antibiotic Spectrum Coverage (DASC): A Novel Metric for Inpatient Antibiotic Consumption
- Creators
- Satoshi Kakiuchi - University of IowaDaniel J Livorsi - University of IowaEli N Perencevich - University of IowaDaniel J Diekema - University of IowaDilek Ince - University of IowaKunatum Prasidthrathsint - University of IowaPatrick Kinn - University of IowaKelly Percival - University of IowaBrett H Heintz - Pharmacy Service, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USAMichihiko Goto - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.75(4), pp.567-576
- DOI
- 10.1093/cid/ciab1034
- PMID
- 34910130
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Grant note
- DOI: 10.13039/100017101, name: National Center for Patient Safety; DOI: 10.13039/100000133, name: Agency for Healthcare Research and Quality, award: K08HS027472; name: VHA Health Services Research and Development; name: Center for Access and Delivery Research and Evaluation, award: CIN 13-412
- Language
- English
- Electronic publication date
- 12/15/2021
- Date published
- 08/15/2022
- Academic Unit
- Infectious Diseases; Epidemiology; Pathology; Pharmacy Practice and Science; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984202255802771
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