The WHO today launched a global campaign urging governments to adopt a tool to reduce the spread of antimicrobial resistance, adverse events and costs.
The AWaRe tool was developed by the OMS Essential Medicines List to contain growing resistance and make antibiotic use safer and more effective. Classification of antibiotics in three groups – Access, observation and reserve – and specifies which antibiotics to use for the most common and serious infections, which should be available at any time in the health system and which should be used sparingly or stored and used only as last resort.
The new campaign aims to increase the percentage of global antibiotic consumption in the Access group to at least 60% and reduce the use of antibiotics most at risk of resistance from the Watch and Reserve groups. The use of Access antibiotics reduces the risk of resistance because they are "narrow spectrum" antibiotics (which target a specific microorganism rather than several). They are also less expensive because they are available in generic formulations.
"Antimicrobial resistance is one of the most urgent health risks of our time and risks undoing a century of medical progress," said Dr. Tedros Adhanom Ghebreyesus, director general of the WHO. "All countries must find a balance between guaranteeing access to life-saving antibiotics and slowing drug resistance by reserving some antibiotics for the most difficult to treat infections. I urge countries to adopt AWaRe, which is a valuable and practical tool to do just that. "
Antimicrobial resistance is a global threat to health and development that continues to grow globally, as evidenced in a recent report of the international coordination group on antimicrobial resistance. Currently, it is estimated that over 50% of antibiotics in many countries are used inappropriately as for the treatment of viruses when they treat only bacterial infections or the use of wrong antibiotics (broader spectrum), thus contributing to the spread of antimicrobial resistance.
One of the most urgent concerns is the spread of resistant gram-negative bacteria, including Acinetobacter, Escherichia coli and Klebsiella pneumoniae. These bacteria, which are commonly seen in hospitalized patients, cause infections such as pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. When antibiotics stop working effectively, more expensive treatments and hospital admissions are needed, with serious repercussions on already stretched health budgets.
At the same time, many low and middle income countries live large gaps in access to effective and appropriate antibiotics. Infant deaths due to pneumonia (estimated globally at nearly one million a year) due to lack of access to antibiotics remain frequent in many parts of the world. And although over 100 countries have developed national plans to counter antimicrobial resistance, only about a fifth of these plans are funded and implemented.
"Tackling antimicrobial resistance requires a careful balance between access and conservation," said Dr. Hanan Balkhy, General Assistant of the WHO for antimicrobial resistance. "The AWaRe tool can guide policy to ensure that patients continue to be treated, while limiting the use of antibiotics most at risk of resistance."
In the absence of significant new investments in the development of new antibiotics, the improvement of antibiotic use is one of the key actions needed to curb the further emergence and spread of antimicrobial resistance. By classifying antibiotics into three distinct groups and advising them on when to use them, AWaRe makes it easier for policy makers, prescribers and healthcare professionals to select the right antibiotic at the right time and protect endangered antibiotics.
"Antimicrobial resistance is an invisible pandemic," said Dr. Mariângela Simão, Assistant Director-General for Access to Medicines. "We are already starting to see the signs of a post-antibiotic, with the emergence of infections that are not curable by all classes of antibiotics. We must safeguard these precious antibiotics of the last line to ensure that we can still cure and prevent serious infections ".
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