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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.author Hsia, Yingfen
dc.contributor.author Lee, Brian L.
dc.contributor.author Versporten, Ann
dc.contributor.author Yang, Yonghong
dc.contributor.author Bielicki, Julia
dc.contributor.author Jackson, Charlotte
dc.contributor.author Newland, Jason
dc.contributor.author Goossens, Herman
dc.contributor.author Magrini, Nicola
dc.contributor.author Sharland, Mike
dc.contributor.author GARPEC network
dc.contributor.author SHARPS collaborative
dc.contributor.author Global-PPS network
dc.contributor.other Cornistein, Wanda
dc.contributor.other Del Castillo, Marcelo Ernesto
dc.date.accessioned 2020-11-18T16:32:05Z
dc.date.available 2020-11-18T16:32:05Z
dc.date.issued 2019-06-11
dc.identifier.citation Hsia, Y., Lee, B.R., Versporten, A., Yang, Y., Bielicki, J., Jackson, C., Newland, J., Goossens, H., Magrini, N., Sharland, M. 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. Lancet Glob Health. 2019 Jul;7(7):e861-e871. doi: 10.1016/S2214-109X(19)30071-3 en_US
dc.identifier.uri https://doi.org/10.1016/S2214-109X(19)30071-3
dc.identifier.uri https://repositorio.fleni.org.ar/handle/123456789/238
dc.description.abstract Background 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. Methods 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. Findings Of the 23 572 patients included from 56 countries, 18 305 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. Interpretation 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. en_US
dc.language.iso eng en_US
dc.publisher Elsevier en_US
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Anti-Bacterial Agents en_US
dc.subject Antibacterianos en_US
dc.subject Child, Hospitalized en_US
dc.subject Niño Hospitalizado en_US
dc.title 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 en_US
dc.type info:eu-repo/semantics/publishedVersion
dc.type info:eu-repo/semantics/article en_US
dc.description.fil Fil: Hsia, Yingfen. St George's University of London; Reino Unido.
dc.description.fil Fil: Lee, Brian L. Children's Mercy Kansas City; Estados Unidos.
dc.description.fil Fil: Versporten, Ann. University of Antwerp; Bélgica.
dc.description.fil Fil: Yang, Yonghong. Capital Medical University; China.
dc.description.fil Fil: Bielicki, Julia. St George's University of London; Reino Unido.
dc.description.fil Fil: Jackson, Charlotte. St George's University of London; Reino Unido.
dc.description.fil Fil: Newland, Jason. Washington University in St Louis Children's Hospital; Estados Unidos.
dc.description.fil Fil: Goossens, Herman. University of Antwerp; Bélgica.
dc.description.fil Fil: Magrini, Nicola. Department of Essential Medicines and Health Products; Suiza.
dc.description.fil Fil: Sharland, Mike. St George's University of London; Reino Unido.
dc.description.fil Fil: Cornistein, Wanda. Fleni. Servicio de Infectología; Argentina.
dc.description.fil Fil: Del Castillo, Marcelo Ernesto. Fleni. Servicio de Infectología; Argentina.
dc.relation.ispartofVOLUME 7
dc.relation.ispartofNUMBER 7
dc.relation.ispartofPAGINATION e861-e871
dc.relation.ispartofCOUNTRY Reino Unido
dc.relation.ispartofCITY Londres
dc.relation.ispartofTITLE The Lancet. Global health
dc.relation.ispartofISSN 2214-109X
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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