Pediatric ASP Toolkit

The World Health Organization

AWaRe Classification (2019) – 

WHO has classified available antibiotics into three categories: Access, Watch and Reserve to help in development of antimicrobial stewardship tool for optimal antimicrobial use and monitoring. 

Access group has antibiotics used commonly for wide range of infections and have less potential of developing resistance.

This list includes Penicillins like Ampicillin, Amoxicillin, Amoxicillin/clavulinic acid, cloxacillin  Aminoglycosides like , amiikacin, gentamicin ,first generation Cephalosporins like cefadroxil, cefazolin,  and Trimethoprim-sulfonamide combinations.

Watch group contains list of antibiotics that are recommended as first and second line treatment for a limited number of infections. Since the potential of development of resistance is high to these antibiotics, the Watch group is considered as the target for stewardship monitoring.

This list includes: Macrolides, second, third generation cepahosporins (except ceftazidime-avibactam) and fourth generation cephalosporins, Carbapenems, fluoroquinolone, Vancomycin, piperacillin-tazobactam. 

Reserve group has antibiotics to be used as last resort only when no better alternative is available. These are mostly used in life threatening multidrug resistant infections.

This list includes: Colistin, Linezolid, Daptomycin, Tigecycline, Minocycline, polymixin B, ceftazidime-avibactam, etc.

For Further information: 

The 2019 WHO AWaRe classification of antibiotics for evaluation and monitoring of use. Geneva: World Health Organization; 2019. (WHO/EMP/IAU/2019.11). Licence: CC BY-NC-SA 3.0 IGO. https://www.who.int/publications/i/item/WHOEMPIAU2019.11

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