TY - JOUR
T1 - WHO's essential medicines and AWaRe
T2 - recommendations on first- and second-choice antibiotics for empiric treatment of clinical infections
AU - Moja, Lorenzo
AU - Zanichelli, Veronica
AU - Mertz, Dominik
AU - Gandra, Sumanth
AU - Cappello, Bernadette
AU - Cooke, Graham S.
AU - Chuki, Pem
AU - Harbarth, Stephan
AU - Pulcini, Celine
AU - Mendelson, Marc
AU - Tacconelli, Evelina
AU - Ombajo, Loice Achieng
AU - Chitatanga, Ronald
AU - Zeng, Mei
AU - Imi, Monica
AU - Elias, Christelle
AU - Ashorn, Per
AU - Marata, Annamaria
AU - Paulin, Sarah
AU - Muller, Arno
AU - Aidara-Kane, Awa
AU - Wi, Teodora Elvira
AU - Were, Wilson Milton
AU - Tayler, Elizabeth
AU - Figueras, Albert
AU - Da Silva, Carmem Pessoa
AU - Van Weezenbeek, Catharina
AU - Magrini, Nicola
AU - Sharland, Mike
AU - Huttner, Benedikt
AU - Loeb, Mark
N1 - Publisher Copyright:
© 2024 World Health Organization
PY - 2024/4
Y1 - 2024/4
N2 - The WHO Model List of Essential Medicines (EML) prioritizes medicines that have significant global public health value. The EML can also deliver important messages on appropriate medicine use. Since 2017, in response to the growing challenge of antimicrobial resistance, antibiotics on the EML have been reviewed and categorized into three groups: Access, Watch, and Reserve, leading to a new categorization called AWaRe. These categories were developed taking into account the impact of different antibiotics and classes on antimicrobial resistance and the implications for their appropriate use. The 2023 AWaRe classification provides empirical guidance on 41 essential antibiotics for over 30 clinical infections targeting both the primary health care and hospital facility setting. A further 257 antibiotics not included on the EML have been allocated an AWaRe group for stewardship and monitoring purposes. This article describes the development of AWaRe, focussing on the clinical evidence base that guided the selection of Access, Watch, or Reserve antibiotics as first and second choices for each infection. The overarching objective was to offer a tool for optimizing the quality of global antibiotic prescribing and reduce inappropriate use by encouraging the use of Access antibiotics (or no antibiotics) where appropriate. This clinical evidence evaluation and subsequent EML recommendations are the basis for the AWaRe antibiotic book and related smartphone applications. By providing guidance on antibiotic prioritization, AWaRe aims to facilitate the revision of national lists of essential medicines, update national prescribing guidelines, and supervise antibiotic use. Adherence to AWaRe would extend the effectiveness of current antibiotics while helping countries expand access to these life-saving medicines for the benefit of current and future patients, health professionals, and the environment.
AB - The WHO Model List of Essential Medicines (EML) prioritizes medicines that have significant global public health value. The EML can also deliver important messages on appropriate medicine use. Since 2017, in response to the growing challenge of antimicrobial resistance, antibiotics on the EML have been reviewed and categorized into three groups: Access, Watch, and Reserve, leading to a new categorization called AWaRe. These categories were developed taking into account the impact of different antibiotics and classes on antimicrobial resistance and the implications for their appropriate use. The 2023 AWaRe classification provides empirical guidance on 41 essential antibiotics for over 30 clinical infections targeting both the primary health care and hospital facility setting. A further 257 antibiotics not included on the EML have been allocated an AWaRe group for stewardship and monitoring purposes. This article describes the development of AWaRe, focussing on the clinical evidence base that guided the selection of Access, Watch, or Reserve antibiotics as first and second choices for each infection. The overarching objective was to offer a tool for optimizing the quality of global antibiotic prescribing and reduce inappropriate use by encouraging the use of Access antibiotics (or no antibiotics) where appropriate. This clinical evidence evaluation and subsequent EML recommendations are the basis for the AWaRe antibiotic book and related smartphone applications. By providing guidance on antibiotic prioritization, AWaRe aims to facilitate the revision of national lists of essential medicines, update national prescribing guidelines, and supervise antibiotic use. Adherence to AWaRe would extend the effectiveness of current antibiotics while helping countries expand access to these life-saving medicines for the benefit of current and future patients, health professionals, and the environment.
KW - Anti-bacterial agents
KW - Anti-bacterial agents/therapeutic use
KW - Antimicrobial
KW - Drug resistance
KW - Drugs
KW - Essential
KW - Guidelines
KW - Humans
KW - Stewardship
KW - World Health Organization
U2 - 10.1016/j.cmi.2024.02.003
DO - 10.1016/j.cmi.2024.02.003
M3 - Article
C2 - 38342438
AN - SCOPUS:85190335451
SN - 1198-743X
VL - 30
SP - S1-S51
JO - CLINICAL MICROBIOLOGY AND INFECTION
JF - CLINICAL MICROBIOLOGY AND INFECTION
ER -
