Introduction: Blood stream infections are the major cause of morbidity and mortality hence early availability of direct susceptibility reports can be lifesaving Initiation of appropriate antimicrobial at right time can improve the outcome in terms of reduced patient distress in addition to reduced health-care costs. Early preliminary Antimicrobial Susceptibility Test (AST) report will be useful in directing antimicrobial therapy. Objective: The objective of the study was to correlate DST (Direct susceptibility testing) by disc diffusion method, directly from positively flagged blood culture bottles, with the AST of bacterial isolates by automated method. Materials and Methods: This prospective study was carried in a tertiary care centre of north India. A total of 300 isolates from patients with blood stream infections were included in the study. Gram staining, bacterial identification, direct susceptibility, antimicrobial susceptibility of all the isolates were documented. Results: Escherichia coli was the commonest isolate (27%), followed by Klebsiella pneumoniae (22%). Overall antimicrobial susceptibility pattern among Gram negative bacterial isolates (n=300) detected by DST and automated AST showed maximum susceptibility to cotrimoxazole 54.3% and 53.8% respectively. Comparison of interpretative results with DST and automated AST showed minimum concordance for piperacillin/tazobactam (92.6% and maximum concordance for ceftriaxone (99%). Conclusion: DST is an important tool for early initiation of targeted therapy and can be considered as one of the step towards antibiotic stewardship intervention.