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WHO's essential medicines and AWaRe: recommendations on first- and second-choice antibiotics for empiric treatment of clinical infections.
Moja, Lorenzo; Zanichelli, Veronica; Mertz, Dominik; Gandra, Sumanth; Cappello, Bernadette; Cooke, Graham S; Chuki, Pem; Harbarth, Stephan; Pulcini, Celine; Mendelson, Marc; Tacconelli, Evelina; Ombajo, Loice Achieng; Chitatanga, Ronald; Zeng, Mei; Imi, Monica; Elias, Christelle; Ashorn, Per; Marata, Annamaria; Paulin, Sarah; Muller, Arno; Aidara-Kane, Awa; Wi, Teodora Elvira; Were, Wilson Milton; Tayler, Elizabeth; Figueras, Albert; Da Silva, Carmem Pessoa; Van Weezenbeek, Catharina; Magrini, Nicola; Sharland, Mike; Huttner, Benedikt; Loeb, Mark.
Afiliación
  • Moja L; Health Products Policy and Standards, World Health Organization, Geneva, Switzerland. Electronic address: mojal@who.int.
  • Zanichelli V; Health Products Policy and Standards, World Health Organization, Geneva, Switzerland.
  • Mertz D; Department of Medicine, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilt
  • Gandra S; Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine in St. Louis, Missouri, United States.
  • Cappello B; Health Products Policy and Standards, World Health Organization, Geneva, Switzerland.
  • Cooke GS; Department of Infectious Diseases, Imperial College London, London, UK.
  • Chuki P; Antimicrobial Stewardship Unit, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
  • Harbarth S; Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; World Health Organization Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva, Switzerland.
  • Pulcini C; APEMAC, and Centre régional en antibiothérapie du Grand Est AntibioEst, Université de Lorraine, CHRU-Nancy, Nancy, France.
  • Mendelson M; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Tacconelli E; Infectious Diseases Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
  • Ombajo LA; Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya; Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya.
  • Chitatanga R; Antimicrobial Resistance National Coordinating Centre, Public Health Institute of Malawi, Blantyre, Malawi.
  • Zeng M; Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
  • Imi M; Independent Consultant, Bergamo, Italy.
  • Elias C; Service Hygiène et Epidémiologie, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon
  • Ashorn P; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.
  • Marata A; Emilia Romagna Health Directorate, Bologna, Italy.
  • Paulin S; Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland.
  • Muller A; Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland.
  • Aidara-Kane A; North Carolina State University, Raleigh, NC, United States.
  • Wi TE; Department of Global HIV, Hepatitis and STIs Programme, World Health Organization, Geneva, Switzerland.
  • Were WM; Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.
  • Tayler E; WHO Regional Office for the Eastern Mediterranean (EMRO), World Health Organisation, Cairo, Egypt.
  • Figueras A; Independent Consultant, Barcelona, Spain.
  • Da Silva CP; Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland; Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Van Weezenbeek C; Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland.
  • Magrini N; NHS Clinical Governance, Romagna Health Authority, Ravenna, Italy; World Health Organization Collaborating Centre for Evidence Synthesis and Guideline Development, Bologna, Italy.
  • Sharland M; Centre for Neonatal and Paediatric Infections, Institute for Infection and Immunity, St George's University of London, London, UK.
  • Huttner B; Health Products Policy and Standards, World Health Organization, Geneva, Switzerland.
  • Loeb M; Department of Medicine, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilt
Clin Microbiol Infect ; 30 Suppl 2: S1-S51, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38342438
ABSTRACT
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Organización Mundial de la Salud / Medicamentos Esenciales / Programas de Optimización del Uso de los Antimicrobianos / Antibacterianos Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Organización Mundial de la Salud / Medicamentos Esenciales / Programas de Optimización del Uso de los Antimicrobianos / Antibacterianos Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido