1. Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): results from a worldwide point prevalence survey in 69 countries
- Author
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Pauwels, Ines, Versporten, Ann, Drapier, Nico, Vlieghe, Erika, Goossens, Herman, Koraqi, Andi, Hoxha, Iris, Tafaj, Silva, Cornistein, Wanda, Quiros, Rodolfo, Hojman, Martin, Ghazaryan, Lilit, Horne, Kylie, Cairns, Kelly, Doukas, Fiona, Gottlieb, Thomas, Sermijn, Erica, Verhamme, Katia, Brands, Christiane, Van Herendael, Bruno, Filippin, Lorenzo, Vandewal, Wouter, Konopnicki, Deborah, Maillart, Evelyne, Teixeira Lopes, Liliana, Papin, Pauline, Smits, Ilse, Jansens, Hilde, Bartholomeus, Sofie, Van den Abeele, Anne-Marie, Steyaert, Sophia, Piette, Anne, Buyle, Franky, Cartuyvels, Reinoud, Jonckheere, Stijn, Wybo, Ingrid, Vanneste, Lorenz, Mathieu, Delphine, Firre, Eric, Westelinck, Veerle, Gadisseux, Philippe, Dugernier, Thierry, Bafort, Kristof, Gonissen, Viviane, Vanderper, Vanessa, Gabriels, Patrick, Weekers, Frank, Michel, Philippe, Van Liedekerke, Ann, Costers, Michiel, Catry, Boudewijn, Dedeic-Ljubovic, Amela, Gales, Ana C., Matos Porto, Ana Paula, Figueiredo Costa, Silvia, Keuleyan, Emma, Beidi, Apollinaire, Cissohko, Youssouph, Blakwe, Habsatou, Batchaya Basile, Ngassa, German, Greg J., Lutes, Sarah, Boswell, Jennifer, Mertz, Dominik, Nguyen, Tuyen, MacLaggan, Timothy, Landry, Daniel, Ang, Anita, Thirion, Daniel J.G., Frenette, Charles, Émond, Yannick, Roberts, Jacqueline, Chang, Sandra, Kosar, Justin, Valiquette, Louis, Dutrisac, Ginette, Afra, Kevin, McGeer, Allison, Carrier, Marie, Grant, Jennifer, Labarca, Jaime, Carvajal, Camila, Lin, HongYi, Wang, Qiang, Yang, Jing, Yang, Wenjie, Cortes, Jorge A., Villalobos-Vindas, Juan, Ramírez-Valverde, Carlos, Horvatic, Jasminka, Pristas, Irina, Paphitou, Niki, Rummukainen, Maija-Liisa, Froissart, Antoine, Vanhems, Philippe, Pagava, Karaman, Korinteli, Irma, Brandt, Tobias, Gaertner, Johannes, Enimil, Anthony, Roilides, Emmanuel, Hajdú, Edit, Sengupta, Sharmila, Singh, Sanjeev, Patil, Priyanka, Poojary, Aruna, Soltani, Jafar, Pouladfar, Gholamreza, Jafarpour, Zahra, Alinia, Cyrus, Ameen, Hadi, Fitzgerald, David, Paul, Mical, Maor, Yasmin, Strahilevitz, Jacob, Chowers, Michal, Temkin, Elizabeth, Luca, Arnoldo, Ishibashi, Noriomi, Gu, Yoshiaki, Darwish Elhajji, Feras, Karabukayeva, Aizhan, Raka, Denis, Kambaralieva, Baktygul, Zarakauska, Lelde, Zarb, Peter, Hernandez Chena, Blanca Estela, Gonzalez-Diaz, Esteban, Corona-Meléndez, JuanCarlos, Torres Erazo, Darwin Stalin, Loza-Jalil, Suria Elizabeth, Molina, Julio, Candelas, Jose Antonio, Mijovic, Gordana, Duborija-Kovacevic, Natasa, Jong, Eefje, Kluytmans, Jan, van Elzakker, Erika, Schweitzer, Valentijn, Davies, Nicola, Iregbu, Kenneth, Nwajiobi-Princewill, Philip, Nwafia, Ifeyinwa, Fasuyi, Temitayo, Aboderin, Aaron, Elikwu, Charles John, Fadeyi, Abayomi, Ola-Bello, Olafoyekemi, Oduyebo, Oyinlola, Adedosu, Akin Nelson, Ekuma, Agantem, Shaqiri, Erjona, Saleem, Zikria, De Los Reyes, Mari Rose, Tavares, Luis, Kim, Nam Joong, Rachina, Svetlana, Alharthi, Alwaleed R., Enani, Mushira, Faried, Osama, Mirghani, Mohamed, Carevic, Biljana, Radulovic, Lili, Dragovac, Gorana, Tan, Sock Hoon, Taljaard, Jantjie, Chibabhai, Vindana, Joiner, Jennifer, Caston, Juan Jose, Núñez-Núñez, María, Martínez-Marcos, Francisco Javier, Ojeda-Burgos, Guillermo, Menendez, Maria Dolores, Retamar, Pilar, Corzo, Juan E., Rattanaumpawan, Pinyo, Salou, Mounerou, Mnif, Basma, Oncul, Ahsen, Babigumira, Peter Ahabwe, Olweny, James, Marshall, Emily, McCorry, Ann, Aldeyab, Mamoon, Khanna, Priya, Gormley, Cairine, Maloney, Sara, Cooper, Mandelin, Blackburn, Laura, Gessner-Wharton, Mallory, Vu, Lam, Greer, Nickie, Gawrys, Gerard, Kronmann, Lisha, Rios, Edgar, Hudson, Melissa, Lindholm, David A., The Global-PPS network, Vriendenkring VUB, Clinical sciences, Microbiology and Infection Control, and Clinical Biology
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Adult ,Microbiology (medical) ,Point prevalence survey ,Latin Americans ,education ,Population ,MEDLINE ,World Health Organization ,Essential medicines ,Antibiotic prescribing ,Anti-Infective Agents ,Environmental health ,Prevalence ,Humans ,AcademicSubjects/MED00740 ,Medicine ,Pharmacology (medical) ,Medical prescription ,Biology ,Original Research ,Pharmacology ,education.field_of_study ,Adult patients ,business.industry ,Pharmacology. Therapy ,Hospitals ,Anti-Bacterial Agents ,Anti-Bacterial Agents/therapeutic use ,AcademicSubjects/MED00290 ,Infectious Diseases ,Human medicine ,AcademicSubjects/MED00230 ,business - Abstract
ObjectivesThe 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.MethodsThe 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.ResultsRegional 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.ConclusionsWe 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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- 2021