A Broad Spectrum of Possibilities: Spectrum Scores as a Unifying Metric of Antibiotic Utilization

Abstract

Days of therapy (DOT) currently serve as the standard antimicrobial utilization metric; however, by assigning the same weight to each agent rather than accounting for differences in spectrum of activity, DOT ignore key differences between agents that are fundamental to infectious diseases and critical to antimicrobial stewardship. Spectrum scoring assigns numeric values to individual antibiotic agents to quantify their spectrum of activity, allowing for normalization of antibiotic utilization data. When used in conjunction with traditional metrics, spectrum scores may offer further clarity to the picture of antibiotic utilization; however, issues related to development, application, and standardization of spectrum scores remain. Despite these challenges, the potential applications of spectrum scores are vast. Herein, we summarize existing data and explore the future of spectrum scoring, including application to both data analysis and routine patient care, use in inpatient and outpatient settings, integration within the electronic medical record, and opportunities for future research.

Improvement in Diagnosis and Management of Nosocomial Pneumonias in a Cardiovascular Surgery Intensive Care Unit: A Multidisciplinary Approach

“…None of post-vs. pre-protocol hospital length of stay (26.2 days [16.7, 43.3] vs. 36.5 days [16.4, 53.2], p= 0.08), ICU length of stay (22.6 days [9.9, 30.4] vs. 11.3 days [6.5, 37.9], p = 0.73), or mechanical ventilation (9.1 days [2.4, 20.3] vs. 6.5 days [0.4, 19.2], p = 0.20) was significantly different between the groups. Median cumulative spectrum scores did not differ between groups either (56 pre-protocol [40,64] vs. 49 [35,70] post-protocol, p = 0.84) [16].…”