• J Vallès, S Fernández, E Cortés, A Morón, E Fondevilla, J C Oliva, and E Diaz.
• Critical Care Department, Hospital Universitari Parc Taulí, Sabadell, Spain. Electronic address: jvalles@tauli.cat.
• Med Intensiva. 2020 Jun 1; 44 (5): 294-300.

ObjectiveTo compare the measurement of antimicrobial consumption by defined daily dose (DDD) versus by days of therapy (DOT).DesignRetrospective analysis of clinical and administrative data from patients admitted to a polyvalent ICU.SettingICU at a University Hospital in Spain.PatientsAll patients admitted to the ICU.InterventionsNone.Main Variables Of InterestFor the DDD method, the World Health Organization (WHO)-assigned DDD was determined for the all the prescribed antimicrobials. For the DOT method, one DOT represented the administration of a single agent on a given day regardless of the number of doses administered. To express aggregate use, total DDDs and total DOTs were normalized to 100 patient-days.ResultsDuring the study period, 2393 adult patients were admitted to the ICU. Total median antimicrobial drugs measured by DDDs was 535.3 (IQR 319.8-845.5) vs. 344.0 (IQR 117.2-544.5) when measured by DOTs, p<0.001. When antimicrobial consumption was normalized to 100 patient-days, median antimicrobial consumption was also higher when measured by DDDs [2.98/100 patient-days (IQR 1.76-5.25) vs. 1.89/100 patient-days (IQR 0.64-3.0) when measured by DOTs, p<0.001].ConclusionsFor most antibacterial and antifungal drugs used in critically ill patients, estimates of aggregate antibiotic use by DDDs per 100 patient-days and DOTs per 100 patient-days are discordant because the administered dose is dissimilar from the WHO-assigned DDD. DOT methods should be recommended to avoid the overestimation that occurs with DDDs in adult critically ill patients.Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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