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.
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.
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DOI：
10.1093/jac/dkab050
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发表时间：
2021-05-12
期刊：
影响因子：
--
通讯作者：
Global-PPS network
中科院分区：
文献类型：
--
作者：
Pauwels I;Versporten A;Drapier N;Vlieghe E;Goossens H;Global-PPS network
世界卫生组织制定了获取、观察和储备（AWaRe）分类，以支持各国和医院促进合理使用抗生素，同时改善这些基本药物的获取。我们的目的是根据成人住院患者 AWaRe 分类描述全球抗生素使用模式。全球抗菌药物消耗和耐药性点流行率调查 (Global-PPS) 使用标准化 PPS 方法收集医院抗生素使用数据。 Global-PPS 2015、2017 和 2018 年数据由 69 个国家的 664 家医院收集，被分为 AWaRe 组，以计算 AWaRe 使用比例、使用 Watch 的比率以及使用选定 Watch 抗生素治疗的最常见适应症。仅分析了成人住院病房的全身抗生素处方。区域接入使用率从西亚和中亚的 28.4% 到大洋洲的 57.7%，而手表使用率在大洋洲最低 (41.3%)，在西亚和中亚最高 (66.1%)。储备金使用率从撒哈拉以南非洲的 0.03% 到拉丁美洲的 4.7% 不等。国家层面的 AWaRe 处方存在很大差异。全世界范围内，手表抗生素被用于一系列截然不同的适应症，包括治疗和预防用途。我们观察到 AWaRe 处方和 Watch 抗生素的高使用率存在很大差异，特别是在中低收入和中高收入国家，其次是高收入国家。世卫组织 AWaRe 分类在地方和国家管理活动中发挥着重要作用，可评估处方模式并为管理活动提供信息和评估。
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. 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. 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. 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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