Preventing Potentially Inappropriate Use of Antibiotics Using the World Health Organization AWaRe Tool

Abstract

Background To avert the rise in antimicrobial resistance, the World Health Organization (WHO) introduced the AWaRe (Access, Watch, Reserve) tool to its Essential Medicines List in 2017. In India, only few studies analyzing the antibiotic prescribing pattern according to AWaRe tool were conducted, most of which included data from wholesale databases. Aim This study was aimed at analyzing the antibiotic prescriptions in the outpatient (OP) clinic of a quaternary care hospital as per the WHO AWaRe tool. Method This observational study collected the details of patients who received at least 1 oral/intravenous antibiotic and visited the OP clinic during August 2018 to August 2019. The data were collected from electronic medical record, and it included patient demographics, department, and name of antibiotics prescribed. The proportion of antibiotic use was measured as per WHO AWaRE tool. Results A total of 23,088 antibiotic prescriptions were collected from 58 departments. It was found that 41.32% of antibiotics were from the Access group, whereas 51.01% were from the Watch group and 1.19% from the Reserve group. Amoxicillin-clavulanic acid (Access), azithromycin (Watch), and linezolid (Reserve) were the commonly prescribed antibiotics in the OP department. Conclusions Considering the overall use, the Watch group antibiotics were used to a great extent compared with that of the Access antibiotics, which contradicts the recommended WHO AWaRe criteria. This simple and easy-to-apply antibiotic use monitoring tool, “AWaRe,” must be aligned with the local antibiogram to serve the patient best.