Antibiotic utilization and de-escalation in cancer patients: a single-center observational study using DASC metrics

Area of Science:

• Pharmacology
• Infectious Diseases
• Oncology

Background:

• Traditional metrics like Days of Therapy (DOT) and Patient-Antibiotic Days (PAD) have limitations in assessing antibiotic consumption.
• Days of Antibiotic Spectrum Coverage (DASC) is a novel metric that quantifies both antibiotic duration and spectrum of activity.
• Evaluating antibiotic consumption is crucial in oncology due to high infection rates and complex treatment regimens.

Purpose of the Study:

• To evaluate antibiotic consumption in cancer patients using the DASC metric.
• To compare DASC with traditional metrics such as DOT and PAD.
• To assess the utility of DASC ratios (DASC/DOT and DASC/PAD) in understanding antibiotic prescribing patterns.

Main Methods:

• A prospective observational study was conducted in oncology wards over a one-year period.
• DASC was calculated as the sum of antibiotic spectrum scores multiplied by treatment duration.
• Data were analyzed using descriptive statistics and Spearman's rank correlation coefficient.

Main Results:

• Cumulative DOT, DASC, and PAD were 1195, 9749, and 757, respectively.
• The DASC/DOT ratio indicated broader spectrum antibiotic use, while the DASC/PAD ratio reflected high-intensity or combination therapy.
• DASC, DOT, and PAD showed strong positive correlations, with DASC/PAD correlating with overall antibiotic intensity and spectrum.

Conclusions:

• The DASC/DOT ratio effectively measures the average antibiotic spectrum used.
• The DASC/PAD ratio evaluates antibiotic intensity and spectrum burden at the patient level.
• DASC, DOT, and PAD can serve as complementary metrics for antimicrobial stewardship programs in oncology.