Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

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dc.contributor.authorHsia, Yingfen
dc.contributor.authorLee, Brian R.
dc.contributor.authorVersporten, Ann
dc.contributor.authorYang, Yonghong
dc.contributor.authorBielicki, Julia
dc.contributor.authorJackson, Charlotte
dc.contributor.authorNewland, Jason
dc.contributor.authorGoossens, Herman
dc.contributor.authorMagrini, Nicola
dc.contributor.authorSharland, Mike
dc.contributor.authorTeston, L.
dc.contributor.authorCheung, K.
dc.contributor.authorKoning, S.
dc.contributor.authorGrimwood, K.
dc.contributor.authorCross, J.
dc.contributor.authorda Silva, A.
dc.contributor.authorBenadof, D.
dc.contributor.authorZhang, W. S.
dc.contributor.authorZhao, W.
dc.contributor.authorLiu, G.
dc.contributor.authorShen, K. L.
dc.contributor.authorYao, K. H.
dc.contributor.authorZheng, Y. J.
dc.contributor.authorDeng, J. K.
dc.contributor.authorZhang, J. S.
dc.contributor.authorWang, Y.
dc.contributor.authorJiang, X. Y.
dc.contributor.authorTian, D. Y.
dc.contributor.authorJing, C. M.
dc.contributor.authorWang, L. J.
dc.contributor.authorCao, S. C.
dc.contributor.authorWu, L. J.
dc.contributor.authorChen, X.
dc.contributor.authorDing, M. J.
dc.contributor.authorZhang, L.
dc.contributor.authorLin, L.
dc.contributor.authorYang, J. H.
dc.contributor.authorCao, Q.
dc.contributor.authorWang, W.
dc.contributor.authorLi, J. P.
dc.contributor.authorTang, L. F.
dc.contributor.authorLiu, J.
dc.contributor.authorWang, P.
dc.contributor.authorQian, J.
dc.contributor.authorZhu, C. M.
dc.contributor.authorLu, G.
dc.contributor.authorDeng, Q. L.
dc.contributor.authorMu, X. P.
dc.contributor.authorZhao, C. A.
dc.contributor.authorDong, X. Y.
dc.contributor.authorZhang, H.
dc.contributor.authorLi, C. Y.
dc.contributor.authorLi, W.
dc.contributor.authorSaxen, H.
dc.contributor.authorKekomaki, S.
dc.contributor.authorHufnagel, M.
dc.contributor.authorRippberger, B.
dc.contributor.authorKnuf, M.
dc.contributor.authorNikolic, P.
dc.contributor.authorHuebner, J.
dc.contributor.authorKreitmeyer, K.
dc.contributor.authorBehrends, U.
dc.contributor.authorRieber, N.
dc.contributor.authorRenk, H.
dc.contributor.authorSpyridis, N.
dc.contributor.authorTsolia, M.
dc.contributor.authorPapaevangelous, V
dc.contributor.authorGkentzi, D.
dc.contributor.authorSyrogiannopoulos, G.
dc.contributor.authorKaffe, K.
dc.contributor.authorRoilides, E.
dc.contributor.authorPitsava, G.
dc.contributor.authorPapadimitriou, E.
dc.contributor.authorIosifidis, E.
dc.contributor.authorGandra, S.
dc.contributor.authorLaxminarayan, R.
dc.contributor.authorAlvarez-Uria, G.
dc.contributor.authorJinka, D.
dc.contributor.authorMurki, Srinivas
dc.contributor.authorKandraju, H.
dc.contributor.authorSingh, S.
dc.contributor.authorVasudevan, A. K.
dc.contributor.authorKanithi, R.
dc.contributor.authorAkula, A.
dc.contributor.authorChikkappa, A.
dc.contributor.authorTunga, O.
dc.contributor.authorSubramanian, S.
dc.contributor.authorSharma, A.
dc.contributor.authorDharmapalan, D.
dc.contributor.authorAshkenazi-Hoffnung, L.
dc.contributor.authorAshkenazi, S.
dc.contributor.authorEsposito, S.
dc.contributor.authorTagliabue, C.
dc.contributor.authorTersigni, C.
dc.contributor.authorGalli, L.
dc.contributor.authorD'Argenio, P.
dc.contributor.authorPansa, P.
dc.contributor.authorDuse, M.
dc.contributor.authorHorikoshi, Y.
dc.contributor.authorFukuoka, K.
dc.contributor.authorJimenez, R.
dc.contributor.authorOjeda, K.
dc.contributor.authorOkokon, I
dc.contributor.authorMahmood, H.
dc.contributor.authorGowin, E.
dc.contributor.authorSlowinska-Jarzabek, B.
dc.contributor.authorMajda-Stanislawska, E.
dc.contributor.authorSicinska, J.
dc.contributor.authorChan, S. M.
dc.contributor.authorChang, A.
dc.contributor.authorRozic, M.
dc.contributor.authorPremru, M.
dc.contributor.authorFinlayson, H.
dc.contributor.authorWhitelaw, A.
dc.contributor.authorRabie, H.
dc.contributor.authorDramowski, A.
dc.contributor.authorO'Connell, N.
dc.contributor.authorEpalza, C.
dc.contributor.authorRojo-Conejo, Pablo
dc.contributor.authorMartinon Torres, Federico
dc.contributor.authorJusticia, Antonio
dc.contributor.authorJian, V
dc.contributor.authorCheng, C. L.
dc.contributor.authorLumbiganon, P.
dc.contributor.authorPaopongsawan, P.
dc.contributor.authorPuthanakit, T.
dc.contributor.authorAnugulruengkitt, S.
dc.contributor.authorYarci, E.
dc.contributor.authorDoerholt, K.
dc.contributor.authorVazouras, K.
dc.contributor.authorBamford, A.
dc.contributor.authorIrwin, A.
dc.contributor.authorDrysdale, S. B.
dc.contributor.authorCollett-White, F.
dc.contributor.authorHarkensee, C.
dc.contributor.authorMcMaster, P.
dc.contributor.authorGreen, H.
dc.contributor.authorRees, S.
dc.contributor.authorLedoare, K.
dc.contributor.authorChappell, F.
dc.contributor.authorJacqueline, D.
dc.contributor.authorHackett, S.
dc.contributor.authorVergnano, S.
dc.contributor.authorPraveen, S.
dc.contributor.authorHerberg, J.
dc.contributor.authorSpeirs, L.
dc.contributor.authorMoriarty, Paul
dc.contributor.authorLacej, D.
dc.contributor.authorHoxha, I
dc.contributor.authorCornistein, W.
dc.contributor.authorQuiros, R.
dc.contributor.authorHojman, M.
dc.contributor.authorDel Castillo, M.
dc.contributor.authorGhazaryan, L.
dc.contributor.authorAlSalman, J.
dc.contributor.authorKonopnicki, D.
dc.contributor.authorPierard, D.
dc.contributor.authorHolemans, X.
dc.contributor.authorSchelstraete, P.
dc.contributor.authorFirre, E.
dc.contributor.authorVan Herendael, B.
dc.contributor.authorDedeic-Ljubovic, A.
dc.contributor.authorPignatari, A.
dc.contributor.authorSabuda, D.
dc.contributor.authorCarvajal, C.
dc.contributor.authorAlvaro, R.
dc.contributor.authorLabarca, J.
dc.contributor.authorSolano, A.
dc.contributor.authorRamirez, C.
dc.contributor.authorMarekovic, I
dc.contributor.authorHorvatic, J.
dc.contributor.authorPristas, I
dc.contributor.authorMarshall, E.
dc.contributor.authorPagava, K.
dc.contributor.authorKorinteli, I
dc.contributor.authorNeubert, A.
dc.contributor.authorEnimil, A.
dc.contributor.authorFrimpong, J. A.
dc.contributor.authorSoltani, J.
dc.contributor.authorFitzgerald, D.
dc.contributor.authorKasahara, K.
dc.contributor.authorGu, Y.
dc.contributor.authorOkinaka, K.
dc.contributor.authorKunishima, H.
dc.contributor.authorElhajji, F. Darwish
dc.contributor.authorAlshehri, M.
dc.contributor.authorRaka, L.
dc.contributor.authorKambaralieva, B.
dc.contributor.authorSviestina, I
dc.contributor.authorBurokiene, S.
dc.contributor.authorUsonis, V
dc.contributor.authorShaqiri, E.
dc.contributor.authorZarb, P.
dc.contributor.authorMarkovic, G.
dc.contributor.authorSimovic, S.
dc.contributor.authorNwajiobi-Princewil, P.
dc.contributor.authorIregbu, K.
dc.contributor.authorAboderin, A.
dc.contributor.authorOduyebo, O.
dc.contributor.authorOlayinka, A.
dc.contributor.authorMcCorry, A.
dc.contributor.authorMcCullagh, B.
dc.contributor.authorGormley, C.
dc.contributor.authorRachina, S.
dc.contributor.authorCarevic, B.
dc.contributor.authorChen, H. H.
dc.contributor.authorLing, M. L.
dc.contributor.authorTerol Barrero, P.
dc.contributor.authorBuijtels, P.
dc.contributor.authorvan Elzakker, E.
dc.contributor.authorThompson, S.
dc.contributor.authorCooper, M.
dc.contributor.authorRios, E.
dc.contributor.authorHudson, M.
dc.contributor.authorGreer, N.
dc.contributor.authorGessner-Wharton, M.
dc.contributor.authorGawrys, G.
dc.date.accessioned2025-01-23T21:12:57Z
dc.date.available2025-01-23T21:12:57Z
dc.date.issued2019
dc.description.abstractBackground Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions.
dc.description.abstractMethods 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications.
dc.description.abstractFindings Of the 23 572 patients included from 56 countries, 18305 were children (77.7%) and 5267 were neonates (22.3%). Access antibiotic use in children ranged from 7.8% (China) to 61.2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77.3%) and lowest in Finland (23.0%). In neonates, Access antibiotic use was highest in Singapore (100.0%) and lowest in China (24.2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries.
dc.description.abstractInterpretation There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.
dc.fuente.origenWOS
dc.identifier.issn2214-109X
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/100985
dc.identifier.wosidWOS:000470996500026
dc.issue.numero7
dc.language.isoen
dc.pagina.finalE871
dc.pagina.inicioE861
dc.revistaLancet global health
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleUse of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries
dc.typeartículo
dc.volumen7
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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