期刊
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
卷 76, 期 6, 页码 1614-1624出版社
OXFORD UNIV PRESS
DOI: 10.1093/jac/dkab050
关键词
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资金
- Flemish government
- bioMerieux
The study analyzed antibiotic use data from 664 hospitals in 69 countries from 2015 to 2018, and found significant variations in AWaRe prescribing patterns globally, especially in the therapeutic and prophylactic use of Watch antibiotics. The WHO AWaRe classification plays a crucial role in assessing and informing stewardship activities at local and national levels.
Objectives: The WHO Access, Watch and Reserve (AWaRe) classification has been developed to support countries and hospitals in promoting rational use of antibiotics while improving access to these essential medicines. We aimed to describe patterns of worldwide antibiotic use according to the AWaRe classification in the adult inpatient population. Methods: The Global Point Prevalence Survey on Antimicrobial Consumption and Resistance (Global-PPS) collects hospital antibiotic use data using a standardized PPS methodology. Global-PPS 2015, 2017 and 2018 data, collected by 664 hospitals in 69 countries, were categorized into AWaRe groups to calculate proportional AWaRe use, Access-to-Watch ratios and the most common indications for treatment with selected Watch antibiotics. Only prescriptions for systemic antibiotics on adult inpatient wards were analysed. Results: Regional Access use ranged from 28.4% in West and Central Asia to 57.7% in Oceania, whereas Watch use was lowest in Oceania (41.3%) and highest in West and Central Asia (66.1%). Reserve use ranged from 0.03% in sub-Saharan Africa to 4.7% in Latin America. There were large differences in AWaRe prescribing at country level. Watch antibiotics were prescribed for a range of very different indications worldwide, both for therapeutic and prophylactic use. Conclusions: We observed considerable variations in AWaRe prescribing and high use of Watch antibiotics, particularly in lower- and upper-middle-income countries, followed by high-income countries. The WHO AWaRe classification has an instrumental role to play in local and national stewardship activities to assess prescribing patterns and to inform and evaluate stewardship activities.
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