{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:48:23Z","timestamp":1761094103121,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Objective: The 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 Methods: The 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 &lt; 6 years and the elderly (\u226565 years). Results: The DASC\/DOT was used to assess the appropriate use of antimicrobials. The DOT\/100 and DASC\/100 prescriptions in 2021\u20132023 were 50.1% and 51.5% lower, respectively, than those before 2020 (p &lt; 0.05). During the same period, the DASC\/DOT decreased by 0.7%, indicating that, despite the decrease in the number of antimicrobial prescriptions, the antimicrobial spectrum did not become narrower. In children &lt; 6 years of age, DOT and DASC values declined significantly, possibly indicating a decrease in the number of antibiotic prescriptions for viral upper respiratory tract infections. In the elderly (\u226565 years), the DASC\/DOT remained relatively high, indicating their continued reliance on broad-spectrum agents, such as fluoroquinolones and macrolides. Conclusions: This 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 (\u226565 years old).<\/jats:p>","DOI":"10.3390\/antibiotics14101051","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:17:35Z","timestamp":1761056255000},"page":"1051","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Days of Antibiotic Spectrum Coverage (DASC) and Oral Antimicrobial-Use Trends at a Community Pharmacy in Japan: A 2018\u20132023 Retrospective Observational Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Kosuke","family":"Hasegawa","sequence":"first","affiliation":[{"name":"MEDIX, Inc. 1-2-3 Motoyokoyamacho, Hachioji 192-0065, Tokyo, Japan"},{"name":"Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji 192-0392, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoji","family":"Seyama","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji 192-0392, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Mori","sequence":"additional","affiliation":[{"name":"MEDIX, Inc. 1-2-3 Motoyokoyamacho, Hachioji 192-0065, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuriko","family":"Matsumura","sequence":"additional","affiliation":[{"name":"MEDIX, Inc. 1-2-3 Motoyokoyamacho, Hachioji 192-0065, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2889-8257","authenticated-orcid":false,"given":"Hidemasa","family":"Nakaminami","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji 192-0392, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"ref_1","unstructured":"The Government of Japan (2025, May 06). National Action Plan on Antimicrobial Resistance (AMR). 2023\u20132027. Available online: https:\/\/www.mhlw.go.jp\/content\/10900000\/001096228.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ijid.2022.03.019","article-title":"Antimicrobial Use Fell Substantially in Japan in 2020\u2014The COVID-19 Pandemic May Have Played a Role","volume":"119","author":"Ono","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijid.2019.11.009","article-title":"Indications and classes of outpatient antibiotic prescriptions in Japan: A descriptive study using the national database of electronic health insurance claims, 2012\u20132015","volume":"91","author":"Hashimoto","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e2440406","DOI":"10.1001\/jamanetworkopen.2024.40406","article-title":"Clinic Characteristics and Antibiotic Prescribing for Acute Respiratory Infections in Japan","volume":"7","author":"Aoyama","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e002364","DOI":"10.1136\/bmjph-2024-002364","article-title":"Association of patient, physician and visit characteristics with inappropriate antibiotic prescribing in Japanese primary care: A cross-sectional study","volume":"3","author":"Miyawaki","year":"2025","journal-title":"BMJ Public Health"},{"key":"ref_6","unstructured":"The AMR One Health Surveillance Committee (2025, June 20). Nippon AMR One Health Report (NAOR) 2024. Available online: https:\/\/www.mhlw.go.jp\/content\/10900000\/001477833.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.cmi.2024.12.005","article-title":"Trends in antimicrobial consumption: Long-term impact of the COVID-19 pandemic","volume":"31","author":"Tsuzuki","year":"2025","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kimura, Y., Fukuda, H., Hayakawa, K., Ide, S., Ota, M., Saito, S., Ishikane, M., Kusama, Y., Matsunaga, N., and Ohmagari, N. (2019). Longitudinal trends of and factors associated with inappropriate antibiotic prescribing for non-bacterial acute respiratory tract infection in Japan: A retrospective claims database study, 2012\u20132017. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223835"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ono, A., Aoyagi, K., Muraki, Y., Asai, Y., Tsuzuki, S., Koizumi, R., Azuma, T., Kusama, Y., and Ohmagari, N. (2021). Trends in healthcare visits and antimicrobial prescriptions for acute infectious diarrhea in individuals aged 65 years or younger in Japan from 2013 to 2018 based on administrative claims database: A retrospective observational study. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06688-2"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"dlaf062","DOI":"10.1093\/jacamr\/dlaf062","article-title":"Significant reduction in antibiotic prescription rates in Japan following implementation of the national action plan on antimicrobial resistance (2016\u201320): A 9-year interrupted time-series analysis","volume":"7","author":"Hashimoto","year":"2025","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1111\/1346-8138.15506","article-title":"Current status of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus isolated from patients with skin and soft tissue infections in Japan","volume":"47","author":"Nakaminami","year":"2020","journal-title":"J. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Hasegawa, K., Mori, T., Asakura, T., Matsumura, Y., and Nakaminami, H. (2023). Surveillance of Antimicrobial Prescriptions in Community Pharmacies Located in Tokyo, Japan. Antibiotics, 12.","DOI":"10.3390\/antibiotics12081325"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"102508","DOI":"10.1016\/j.jiac.2024.08.023","article-title":"Chronic amoxicillin shortage led to alternative broad-spectrum antimicrobial use in pediatric clinics","volume":"31","author":"Otsubo","year":"2025","journal-title":"J. Infect. Chemother."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tanuma, M., Sakurai, T., Nakaminami, H., and Tanaka, M. (2024). Evaluation of antimicrobial stewardship activities using antibiotic spectrum coverage. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-64944-2"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s40780-021-00206-x","article-title":"Impact of an antimicrobial stewardship in a 126-bed community hospital with close communication between pharmacists working on post-prescription audit, ward pharmacists, and the antimicrobial stewardship team","volume":"7","author":"Nakamura","year":"2021","journal-title":"J. Pharm. Health Care Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/ice.2024.137","article-title":"Antibiotic spectrum coverage scoring as a potential metric for evaluating the antimicrobial stewardship team activity: A single-center study","volume":"45","author":"Oda","year":"2024","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Muraki, Y., Maeda, M., Inose, R., Yoshimura, K., Onizuka, N., Takahashi, M., Kawakami, E., Shikamura, Y., Son, N., and Iwashita, M. (2022). Exploration of Trends in Antimicrobial Use and Their Determinants Based on Dispensing Information Collected from Pharmacies throughout Japan: A First Report. Antibiotics, 11.","DOI":"10.3390\/antibiotics11050682"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1093\/cid\/ciab1034","article-title":"Days of Antibiotic Spectrum Coverage: A Novel Metric for Inpatient Antibiotic Consumption","volume":"75","author":"Kakiuchi","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1017\/ice.2022.312","article-title":"Tracking antimicrobial stewardship activities beyond days of therapy (DOT): Comparison of days of antibiotic spectrum coverage (DASC) and DOT at a single center","volume":"44","author":"Suzuki","year":"2023","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Maeda, M., Nakata, M., Naito, Y., Yamaguchi, K., Yamada, K., Kinase, R., Takuma, T., On, R., and Tokimatsu, I. (2022). Days of Antibiotic Spectrum Coverage Trends and Assessment in Patients with Bloodstream Infections: A Japanese University Hospital Pilot Study. Antibiotics, 11.","DOI":"10.3390\/antibiotics11121745"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jiac.2023.10.012","article-title":"Trends in inpatient antimicrobial consumption using days of therapy and days of antibiotic spectrum coverage: A nationwide claims database study in Japan","volume":"30","author":"Kanda","year":"2024","journal-title":"J. Infect. Chemother."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"102650","DOI":"10.1016\/j.jiac.2025.102650","article-title":"Days of antibiotic spectrum coverage (DASC) as predictors of recurrent Clostridioides difficile infection: A retrospective cohort study","volume":"31","author":"Mori","year":"2025","journal-title":"J. Infect. Chemother."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e175","DOI":"10.1017\/ash.2025.10086","article-title":"Feasibility and utility of the days of antibiotic spectrum coverage (DASC) in national antimicrobial use surveillance in Japan","volume":"5","author":"Kawamura","year":"2025","journal-title":"Antimicrob. Steward. Healthc. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"102667","DOI":"10.1016\/j.jiac.2025.102667","article-title":"Assignments of antibiotic spectrum coverage scores of antibiotic agents approved in Japan: Utilization of the days of antibiotic spectrum coverage","volume":"31","author":"Maeda","year":"2025","journal-title":"J. Infect. Chemother."},{"key":"ref_25","unstructured":"(2025, May 06). Japan Pediatric Society. Available online: https:\/\/www.jpeds.or.jp\/modules\/news2\/index.php?content_id=906."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.cmi.2020.12.018","article-title":"Antibiotic prescribing in patients with COVID-19: Rapid review and meta-analysis","volume":"27","author":"Langford","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Abdelsalam Elshenawy, R., Umaru, N., and Aslanpour, Z. (2023). WHO AWaRe classification for antibiotic stewardship: Tackling antimicrobial resistance\u2014A descriptive study from an English NHS Foundation Trust prior to and during the COVID-19 pandemic. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1298858"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hendrix, C., McCrary, M., Hou, R., and Abate, G. (2022). Diagnosis and Management of Pulmonary NTM with a Focus on Mycobacterium avium Complex and Mycobacterium abscessus: Challenges and Prospects. Microorganisms, 11.","DOI":"10.3390\/microorganisms11010047"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100244","DOI":"10.1016\/j.jctube.2021.100244","article-title":"Approach to the diagnosis and treatment of non-tuberculous mycobacterial disease","volume":"24","author":"Pennington","year":"2021","journal-title":"J. Clin. Tuberc. Other Mycobact. Dis."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/10\/1051\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:39:01Z","timestamp":1761057541000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/10\/1051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,21]]},"references-count":29,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["antibiotics14101051"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14101051","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,21]]}}}