ArticleAntibiotics (Basel, Switzerland)2025
Days of Antibiotic Spectrum Coverage (DASC) and Oral Antimicrobial-Use Trends at a Community Pharmacy in Japan: A 2018-2023 Retrospective Observational Study.
Article in Antibiotics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe high frequency of prescribing oral antimicrobial agents, such as third-generation cephalosporins, macrolides, and fluoroquinolones, in local clinics is a major issue that can lead to the emergence of antimicrobial-resistant bacteria in the community. Hospitals have recently adopted the days of antibiotic spectrum coverage (DASC), which considers the antibacterial spectrum as a novel indicator of appropriate antimicrobial use. Although it has been used in inpatient settings, its applicability in community pharmacy settings remains unclear. MATERIALS AND
methodsThe aim of this study was to determine whether the DASC is a valuable indicator of appropriate antimicrobial use in community pharmacies. We tabulated the use of antimicrobials dispensed at one of our pharmacies in Tokyo from 1 January 2018, to 31 December 2023. The DASC/100 prescriptions were calculated using the Antibiotic Spectrum Coverage score, which quantifies the extent of antimicrobial activity against key organisms. Higher scores indicate broader-spectrum agents, whereas lower scores indicate narrower-spectrum agents. Additionally, the days of therapy (DOT) value was calculated, along with the DOT/100 prescriptions, based on the dispensed prescriptions. Subgroup analyses were conducted for pediatric children aged < 6 years and the elderly (≥65 years).
resultsThe DASC/DOT was used to assess the appropriate use of antimicrobials. The DOT/100 and DASC/100 prescriptions in 2021-2023 were 50.1% and 51.5% lower, respectively, than those before 2020 (
conclusionsThis study demonstrates the feasibility and benefits of the DASC/DOT as a spectrum-based indicator for appropriate antimicrobial use in community pharmacies. Therefore, the DASC/DOT serves as a practical and spectrum-sensitive indicator of outpatient antimicrobial use to guide antimicrobial stewardship in community settings. Furthermore, age-specific analyses highlighted the importance of targeted interventions to promote the judicious use of broad-spectrum antimicrobials, particularly among the elderly (≥65 years old).
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