Need to improve availability of “access” group antibiotics and reduce the use of “watch” group antibiotics in India for optimum use of antibiotics to contain antimicrobial resistance

[摘要] Antimicrobial resistance (AMR) is a growing public health threat and one of its biggest drivers is inappropriate use of antibiotics [1]. To optimize the use of antimicrobials, the World Health Organization (WHO) in 2017 updated the Essential Medicine List (EML) and categorized the antibiotics into three groups- Access, Watch and Reserve (AWaRe) [2]. The Access group antibiotics are the first and second choices for empirical treatment of 21 common clinical syndromes. First choices are narrow spectrum agents whereas second choice are broad spectrum agents with higher resistance potential. Antibiotics such as amoxicillin/ampicillin, benzathine penicillin, trimethoprim-sulfamethoxazole, amoxicillin-clavulanic acid, cloxacillin are first choice agents. Watch group includes antibiotics with high resistance potential when compared with the Access group and includes antibiotics such as third generation cephalosporins, fluoroquinolones and carbapenems. The Reserve group includes antibiotics of last-resort like polymyxins, fourth and fifth generation cephalosporins. WHO recommends that Access group of antibiotics should be widely available and at an affordable cost and minimize the use of other two groups of antibiotics. A recent report analyzed antibiotic sales data in India between 2007 and 2012 which showed that the consumption of Watch group and Reserve group antibiotics are increasing rapidly when compared to Access group of antibiotics [3]. Here we discuss the consumption patterns of certain antibiotics in Access group and Watch group and the reasons for their consumption patterns.

[学科分类] 药理学