ORIGINAL RESEARCH article
Front. Antibiot.
Sec. Antibiotics in Clinical Settings
Volume 4 - 2025 | doi: 10.3389/frabi.2025.1578217
This article is part of the Research TopicAntibiotic consumption in hospitals and its impact on bacterial resistanceView all 3 articles
Assessment of Antibiotic Utilization Patterns in Indian Level-1 Trauma Centre: A Pilot Study Exploring Days of Antibiotic Spectrum Coverage (DASC) and Defined Daily Doses (DDD) using WHO AWaRe Classification Trends
Provisionally accepted
M Nizam AhmedArpan kumarsmriti srivastavaAparna ningombamMadhavi Kirti
Sushma Sagar
Keshav Goyal
Subodh KumarAshish Bindra
Gyaninder Pal SinghNavdeep KumarRicha aggarwalVijay SharmaSamarth MittalKamran farooque
Purva Mathur*- All India Institute of Medical Sciences, New Delhi, India
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Background: Rising antimicrobial resistance (AMR) demands innovative metrics like Days of Antibiotic Spectrum Coverage (DASC) to optimize antibiotic stewardship. This study evaluated antibiotic use in an Indian trauma centre using DASC, Defined Daily Doses (DDD), and WHO AWaRe classification. Methods: A retrospective cohort study analyzed 1,812 adult inpatients (mean age 35 years, 70% male, 80% polytrauma) at a 250-bed Level-1 Trauma Centre, AIIMS, India, from August to October 2022. We measured DOT, DDD, and DASC for 46 antibiotics across 12 pathogens (e.g., MSSA, carbapenem-resistant Enterobacteriaceae). DASC scores, developed via expert consensus and local antibiogram data, were validated by Pearson's correlation with DOT (R=0.43, p<0.1) and DDD (R=0.21). SPSS v26 facilitated t-tests for ICU vs. ward comparisons.Results: Antibiotic consumption totalled 81,064.6 g (3,142 DDD/1,000 patient-days). Watch group antibiotics dominated (37%, 16,018.6 g), with a low Access-to-Watch ratio (0.47). ICUs had higher DDD (326 vs.193/1,000 patient-days, p<0.05) and DASC/DOT ratios (3, 95% CI: 2.73-4.01). Piperacillin-tazobactam led Watch use (5,952.9 g). DASC (mean 4401.5, 95% CI: 3592-5211.1) showed moderate correlation with DOT (R=0.43, p<0.1), highlighting spectrum-specific insights.Conclusions: Excessive Watch group use fuels AMR, but DASC's novel spectrum-focused approach revolutionizes stewardship by enabling precise de-escalation and benchmarking. This study's findings demand urgent policy reforms to enforce AWaRe adherence in Indian centres, potentially slashing AMR-related mortality (30% higher with resistant infections). Integrating DASC into global AMS programs could redefine antibiotic prescribing, curbing the AMR crisis.
Keywords: DASC, AMR (antimicrobial resistance), antimicrobial resist ance, DOT, ddd, antibiotics
Received: 24 Mar 2025; Accepted: 18 Jun 2025.
Copyright: © 2025 Ahmed, kumar, srivastava, ningombam, Kirti, Sagar, Goyal, Kumar, Bindra, Singh, Kumar, aggarwal, Sharma, Mittal, farooque and Mathur. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Purva Mathur, All India Institute of Medical Sciences, New Delhi, India
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