The global rise in inappropriate antibiotic use is a threat to population health because it is making bacteria resistant to those antibiotics, which makes them ineffective. Over 90% of human antibiotic use is in primary healthcare, with rapidly increasing and inappropriate use of antibiotics seen in low- and middle-income countries.
Sponsor
City St George’s, University of London
Funder
Wellcome Trust
Clinical Trials Unit
Oxford University Clinical Research Unit, Vietnam
Duration
48 Months
Location
Bangladesh, Ghana, Indonesia, Nigeria, Vietnam
Rationale
The World Health Organization (WHO) has developed a classification system called AWaRe (Access, Watch, Reserve) to help guide better use of antibiotics:
Access
Safer, less expensive, and narrow-spectrum antibiotics.
Watch
Broader spectrum, generally more expensive, and with higher safety concerns.
Reserve
Last resort antibiotics, used primarily in hospital settings.
There is a very limited evidence base for interventions to improve the quality of prescribing in low- and middle-income countries (LMICs) primary healthcare settings. The development of the AWaRe system by the WHO as a quality improvement programme, and the recent launch of the WHO AWaRe Book providing guidance on optimal antibiotic use, provides an opportunity to build the evidence base in this critically important area.
AWaRe1 hopes to tackle this challenge through a novel framework for future surveillance, benchmarking, and population-based interventional trials of optimal antibiotic use.
