Maeda Masayuki, Nakata Mari, Naito Yuika, Yamaguchi Kozue, Yamada Kaho, Kinase Ryoko, Takuma Takahiro, On Rintaro, Tokimatsu Issei
Division of Infection Control Sciences, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.
Department of Hospital Pharmaceutics, Showa University School of Pharmacy, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.
Antibiotics (Basel). 2022 Dec 2;11(12):1745. doi: 10.3390/antibiotics11121745.
The antibiotic spectrum is not reflected in conventional antimicrobial metrics. Days of antibiotic spectrum coverage (DASC) is a novel quantitative metric for antimicrobial consumption developed with consideration of the antibiotic spectrum. However, there were no data regarding disease and pathogen-specific DASC. Thus, this study aimed to evaluate the DASC trend in patients with bloodstream infections (BSIs). DASC and days of therapy (DOT) of in-patients with positive blood culture results during a 2-year interval were evaluated. Data were aggregated to calculate the DASC, DOT, and DASC/DOT per patient stratified by pathogens. During the 2-year study period, 1443 positive blood culture cases were identified, including 265 suspected cases of contamination. The overall DASC, DASC/patient, DOT, DOT/patient, and DASC/DOT metrics were 226,626; 157.1; 28,778; 19.9; and 7.9, respectively. A strong correlation was observed between DASC and DOT, as well as DASC/patient and DOT/patient. Conversely, DASC/DOT had no correlation with other metrics. The combination of DASC and DOT would be a useful benchmark for the overuse and misuse evaluation of antimicrobial therapy in BSIs. Notably, DASC/DOT would be a robust metric to evaluate the antibiotic spectrum that was selected for patients with BSIs.
抗生素谱未反映在传统的抗菌指标中。抗生素谱覆盖天数（DASC）是一种考虑抗生素谱而开发的新型抗菌药物使用定量指标。然而，尚无关于疾病和病原体特异性DASC的数据。因此，本研究旨在评估血流感染（BSI）患者的DASC趋势。对2年期间血培养结果呈阳性的住院患者的DASC和治疗天数（DOT）进行了评估。汇总数据以计算每位患者按病原体分层的DASC、DOT和DASC/DOT。在2年的研究期间，共识别出1443例血培养阳性病例，其中包括265例疑似污染病例。总体DASC、DASC/患者、DOT、DOT/患者和DASC/DOT指标分别为226,626、157.1、28,778、19.9和7.9。观察到DASC与DOT以及DASC/患者与DOT/患者之间存在强相关性。相反，DASC/DOT与其他指标无相关性。DASC和DOT的组合将是评估BSI中抗菌治疗过度使用和滥用的有用基准。值得注意的是，DASC/DOT将是评估为BSI患者选择的抗生素谱的有力指标。
