Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Abstract

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or "golden rules," for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice.

Keywords: Antibiotic therapy; Antimicrobial resistance; Antimicrobial stewardship programs; Hospital-acquired infections; Infection prevention and control; Surgical site infections; Systemic antibiotic prophylaxis.

Fig. 1

The 10 “golden rules” for optimal antibiotic use in hospital settings, which clinicians should always follow in their clinical practice

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Worldwide Antibiotic Resistance National/International Network Group (WARNING)

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Antimicrobial resistance

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Principal mechanisms of antimicrobial resistance

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Classification of drug-resistant bacteria

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One Health

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Healthcare-associated infections

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The five moments for hand hygiene

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The 8 WHO “core components” for the implementation of infection prevention and control

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Finding the right balance in prescribing antibiotics

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How antimicrobial resistance develops

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Selecting the most appropriate antibiotic(s) for a specific patient

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AWaRe classification

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Supporting a cohesive and multidisciplinary approach