Kakiuchi et al developed the Antibiotic Spectrum Coverage (ASC) concept for measuring inpatient antibiotic consumption. Its concept derives from the antibiotic spectrum index (ASI). The authors are from the University of Iowa and the Iowa City Veterans Affairs Health Care System.
Various scores:
(1) days of therapy (DOT): number of antibiotics given on a particular day.
(2) cumulative days of therapy: summation of the DOT for every day that antibiotics are given
(3) antibiotic spectrum coverage for an antibiotic (ASC)
(4) days of antibiotic spectrum coverage (DASC): sum of ASCs for antibiotics given on a particular day, regardless of overlap in spectrum
(5): sum of DASC scores for every day that antibiotics are given
The ASC is derived based on observation of in vitro antibiotic activity against certain organisms:
(1) 11 organisms forming a wild type category
(2) 5 organisms forming an acquired resistance category (extended-spectrum beta-lactamase producing Enterobacteriaceae, MRSA, penicillin resistant Streptococcus pneumoniae, VRE, and carbapenem resistant Enterobacteriaceae)
For the sake of simplicity, the impacts of pharmacodynamics, pharmacokinetics and toxicity are not considered.
