The WHO essential medicines list AWaRe book: from a list to a quality improvement system

Michael Sharland¹, Veronica Zanichelli², Loice Achieng Ombajo³, Joel Bazira⁴, Bernadette Cappello⁵, Ronald Chitatanga⁶, Pem Chuki⁷, Sumanth Gandra⁸, Haileyesus Getahun⁹, Stephan Harbarth¹⁰, Mark Loeb¹¹, Marc Mendelson¹², Lorenzo Moja⁵, Celine Pulcini¹³, Hatim Sati⁹, Evelina Tacconelli¹⁴, Mei Zeng¹⁵, Benedikt Huttner¹⁶

Affiliations

¹ Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George's University of London, London, United Kingdom.
² Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Health Product Policy and Standards, Division of Access to Medicines and Health Products, Geneva, Switzerland.
³ Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya.
⁴ Department of Microbiology and Parasitology, Mbarara University of Science and Technology, Mbarara, Uganda.
⁵ Department of Health Product Policy and Standards, Division of Access to Medicines and Health Products, Geneva, Switzerland.
⁶ Antimicrobial Resistance National Coordinating Centre, Public Health Institute of Malawi (PHIM), Blantyre, Malawi.
⁷ Antimicrobial Stewardship Unit(,) Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
⁸ Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine, Saint Louis, MO, United States.
⁹ Department of Global Coordination and Partnership, Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland.
¹⁰ Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
¹¹ Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.
¹² Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
¹³ APEMAC, Université de Lorraine, Nancy, France; Infectious Diseases Department, Université de Lorraine, CHRU-Nancy, Nancy, France.
¹⁴ Infectious Diseases Unit, Department of Diagnostics and Public Health, University of Verona, Italy.
¹⁵ Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
¹⁶ Department of Health Product Policy and Standards, Division of Access to Medicines and Health Products, Geneva, Switzerland. Electronic address: bhuttner@who.int.

PMID: 36007869
DOI: 10.1016/j.cmi.2022.08.009

Free article

The WHO essential medicines list AWaRe book: from a list to a quality improvement system

Michael Sharland et al. Clin Microbiol Infect. 2022 Dec.

Free article

. 2022 Dec;28(12):1533-1535.

doi: 10.1016/j.cmi.2022.08.009. Epub 2022 Aug 22.

Authors

Affiliations

¹ Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George's University of London, London, United Kingdom.
² Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Health Product Policy and Standards, Division of Access to Medicines and Health Products, Geneva, Switzerland.
³ Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya.
⁴ Department of Microbiology and Parasitology, Mbarara University of Science and Technology, Mbarara, Uganda.
⁵ Department of Health Product Policy and Standards, Division of Access to Medicines and Health Products, Geneva, Switzerland.
⁶ Antimicrobial Resistance National Coordinating Centre, Public Health Institute of Malawi (PHIM), Blantyre, Malawi.
⁷ Antimicrobial Stewardship Unit(,) Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
⁸ Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine, Saint Louis, MO, United States.
⁹ Department of Global Coordination and Partnership, Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland.
¹⁰ Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
¹¹ Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.
¹² Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
¹³ APEMAC, Université de Lorraine, Nancy, France; Infectious Diseases Department, Université de Lorraine, CHRU-Nancy, Nancy, France.
¹⁴ Infectious Diseases Unit, Department of Diagnostics and Public Health, University of Verona, Italy.
¹⁵ Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
¹⁶ Department of Health Product Policy and Standards, Division of Access to Medicines and Health Products, Geneva, Switzerland. Electronic address: bhuttner@who.int.

PMID: 36007869
DOI: 10.1016/j.cmi.2022.08.009

Abstract

Antibiotics are often prescribed inappropriately, either when they are not necessary or with an unnecessarily broad spectrum of activity. AWaRe (AccessWatchReserve) is a system developed by WHO to classify antibiotics based on their spectrum of activity and potential for favouring the development of antibiotic resistance (Access: narrow spectrum/low potential for resistance; Watch: broader spectrum/higher potential for resistance; Reserve: last resort antibiotics to use very selectively). The WHO target is that by 2023, at least 60% of prescribed antibiotics globally should be from the Access category. The WHO AWaRe Book aims to improve empiric antibiotic prescribing by providing simple guidance for common infections based on the principles of AWaRe in alignment with the Model Lists of Essential Medicines for adults and children.

Keywords: Antibiotic use; Guidance; Health policy; Infectious disease; Public health.

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The WHO essential medicines list AWaRe book: from a list to a quality improvement system

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The WHO essential medicines list AWaRe book: from a list to a quality improvement system

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