The WHO AWaRe Classification is a method to categorize antibiotics into three groups in an effort to improve appropriate antibiotic use.[1][2] The classification is based, in part, on the risk of developing antibiotic resistance and their importance to medicine.[1][3] It does not reflect effectiveness or strength.[4] It is accompanied by a book that outlines which and how to use antibiotics in 34 common infections.[5]
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The three groups are "access", meaning use can be unrestricted, "watch", meaning care should be taken, and "reserve" meaning use should be saved for cases in which other options are not possible.[3] The recommendation is that greater than 60% of antibiotics used within a country come from the "access" group.[6]
The classification was developed by the World Health Organization (WHO) and launched in 2017.[1] It is an aspect of the WHO Model List of Essential Medicines.[3] The classification as of 2021 covers 258 items.[1] Challenges in its implementation include lack of awareness, little political will, and few resources.[6]
Antibiotics in the watch group are typically broad-spectrum antibiotics with a greater risk of resistance.[6] They are generally only recommended if other options are not possible.[3] They should be used carefully to save their effectiveness for those cases in which "access" antibiotics are not appropriate.[7] Costs are also generally greater, and they are highlighted in yellow.[3] Included in this category are azithromycin, Cefixime, several cephalosporins, ciprofloxacin, clarithromycin, and vancomycin.[5] About 40% are available by mouth.[4]
Reserveedit
The reserve group are generally last line options and used for infections not treatable by other antibiotics, i.e. multi-drug-resistant organisms.[3][7] They are highlighted in red.[3] Include in this category are ceftazidime/avibactam, colistin, polymyxin B (by mouth and by injection), and linezolid.[1][5] The intravenous formulation of fosfomycin is reserve while the by mouth formulation is watch.[1] About 10% of this group is available by mouth.[4]
Not recommendededit
An occasionally included fourth group defines antibiotics whose use is not recommended.[3]
Referencesedit
^ abcdef"2021 AWaRe classification". www.who.int. from the original on 3 August 2023. Retrieved 16 August 2023.
^"2.3.5. WHO model lists of essential medicines". WHO Expert Committee on Biological Standardization: seventy-sixth report. Geneva: World Health Organization. 2023. pp. 17–18. ISBN978-92-4-007448-4. from the original on 2023-11-19. Retrieved 2023-11-17.
^ abcdefghijThe WHO AWaRe (Access, Watch, Reserve) antibiotic book. 9 December 2022. from the original on 13 August 2023. Retrieved 16 August 2023.
^ abcd"WHO Antibiotics Portal". aware.essentialmeds.org. Retrieved 20 November 2023.
^ abcdZanichelli V, Sharland M, Cappello B, Moja L, Getahun H, Pessoa-Silva C, Sati H, van Weezenbeek C, Balkhy H, Simão M, Gandra S, Huttner B (1 April 2023). "The WHO AWaRe (Access, Watch, Reserve) antibiotic book and prevention of antimicrobial resistance". Bulletin of the World Health Organization. 101 (4): 290–296. doi:10.2471/BLT.22.288614. ISSN 0042-9686. PMC10042089.
^ abcdMudenda S, Daka V, Matafwali SK (2023). "World Health Organization AWaRe framework for antibiotic stewardship: Where are we now and where do we need to go? An expert viewpoint". Antimicrobial Stewardship & Healthcare Epidemiology: ASHE. 3 (1): e84. doi:10.1017/ash.2023.164. ISSN 2732-494X. PMC10173285. PMID 37179758.
^ abcdWorld Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
External linksedit
The WHO AWaRe (Access, Watch, Reserve) antibiotic book. 9 December 2022. from the original on 13 August 2023. Retrieved 16 August 2023.
February 16, 2024
aware, classification, method, categorize, antibiotics, into, three, groups, effort, improve, appropriate, antibiotic, classification, based, part, risk, developing, antibiotic, resistance, their, importance, medicine, does, reflect, effectiveness, strength, a. The WHO AWaRe Classification is a method to categorize antibiotics into three groups in an effort to improve appropriate antibiotic use 1 2 The classification is based in part on the risk of developing antibiotic resistance and their importance to medicine 1 3 It does not reflect effectiveness or strength 4 It is accompanied by a book that outlines which and how to use antibiotics in 34 common infections 5 World Health Organization LogoThe three groups are access meaning use can be unrestricted watch meaning care should be taken and reserve meaning use should be saved for cases in which other options are not possible 3 The recommendation is that greater than 60 of antibiotics used within a country come from the access group 6 The classification was developed by the World Health Organization WHO and launched in 2017 1 It is an aspect of the WHO Model List of Essential Medicines 3 The classification as of 2021 covers 258 items 1 Challenges in its implementation include lack of awareness little political will and few resources 6 Contents 1 Classification 1 1 Access 1 2 Watch 1 3 Reserve 1 4 Not recommended 2 References 3 External linksClassification editAccess edit Antibiotics in the access group have a lower risk of antibiotic resistance and are typically recommended as first and second line treatments of infections 6 7 They are generally inexpensive and safe 3 They should be readily available when needed and are highlighted in green 3 7 Access group antibiotics include amikacin amoxicillin amoxicillin clavulanic acid ampicillin benzylpenicillin cefalexin chloramphenicol clindamycin doxycycline Metronidazole and nitrofurantoin 5 Nearly 60 can be taken by mouth 4 Watch edit Antibiotics in the watch group are typically broad spectrum antibiotics with a greater risk of resistance 6 They are generally only recommended if other options are not possible 3 They should be used carefully to save their effectiveness for those cases in which access antibiotics are not appropriate 7 Costs are also generally greater and they are highlighted in yellow 3 Included in this category are azithromycin Cefixime several cephalosporins ciprofloxacin clarithromycin and vancomycin 5 About 40 are available by mouth 4 Reserve edit The reserve group are generally last line options and used for infections not treatable by other antibiotics i e multi drug resistant organisms 3 7 They are highlighted in red 3 Include in this category are ceftazidime avibactam colistin polymyxin B by mouth and by injection and linezolid 1 5 The intravenous formulation of fosfomycin is reserve while the by mouth formulation is watch 1 About 10 of this group is available by mouth 4 Not recommended edit An occasionally included fourth group defines antibiotics whose use is not recommended 3 References edit a b c d e f 2021 AWaRe classification www who int Archived from the original on 3 August 2023 Retrieved 16 August 2023 2 3 5 WHO model lists of essential medicines WHO Expert Committee on Biological Standardization seventy sixth report Geneva World Health Organization 2023 pp 17 18 ISBN 978 92 4 007448 4 Archived from the original on 2023 11 19 Retrieved 2023 11 17 a b c d e f g h i j The WHO AWaRe Access Watch Reserve antibiotic book 9 December 2022 Archived from the original on 13 August 2023 Retrieved 16 August 2023 a b c d WHO Antibiotics Portal aware essentialmeds org Retrieved 20 November 2023 a b c d Zanichelli V Sharland M Cappello B Moja L Getahun H Pessoa Silva C Sati H van Weezenbeek C Balkhy H Simao M Gandra S Huttner B 1 April 2023 The WHO AWaRe Access Watch Reserve antibiotic book and prevention of antimicrobial resistance Bulletin of the World Health Organization 101 4 290 296 doi 10 2471 BLT 22 288614 ISSN 0042 9686 PMC 10042089 a b c d Mudenda S Daka V Matafwali SK 2023 World Health Organization AWaRe framework for antibiotic stewardship Where are we now and where do we need to go An expert viewpoint Antimicrobial Stewardship amp Healthcare Epidemiology ASHE 3 1 e84 doi 10 1017 ash 2023 164 ISSN 2732 494X PMC 10173285 PMID 37179758 a b c d World Health Organization 2023 The selection and use of essential medicines 2023 web annex A World Health Organization model list of essential medicines 23rd list 2023 Geneva World Health Organization hdl 10665 371090 WHO MHP HPS EML 2023 02 External links editThe WHO AWaRe Access Watch Reserve antibiotic book 9 December 2022 Archived from the original on 13 August 2023 Retrieved 16 August 2023 Retrieved from https en wikipedia org w index php title WHO AWaRe amp oldid 1205449205, wikipedia, wiki, book, books, library,
