From Nature, 13 December 2023:
Faced with a skyrocketing rate of antimicrobial resistance, which is estimated to cause or contribute to millions of deaths around the world each year, the World Health Organization (WHO) in 2017 created a classification system for antimicrobial drugs.
The WHO’s system, AWaRe, places all available antimicrobials into three categories: access, watch and reserve. Access is for highly targeted compounds that are relatively unlikely to contribute to antimicrobial resistance, so these should be the most accessible and widely used. Watch is for those that should be used more sparingly and for patients who are the most sick, because they have a greater likelihood of contributing to the emergence of resistance in bacteria. Reserve is for antibiotics of last resort that are meant to be used only in severe, multidrug-resistant infection, when all other options have been exhausted.
In India, however, the rate at which those in the access group are used has been declining relative to the broad-spectrum ones in the watch and reserve groups, which are often prescribed inappropriately. In 2019, just 27% of prescribed antibiotic doses came from the access category, compared with about 55% from the watch list. Read more…
Bianca Nogrady 