Goal
This project aimed to compare observed patterns of empiric antibiotic use in hospitals against the expected if empirical treatments for common infections followed the WHO AWaRe (Access, Watch, Reserve) antibiotic book’s guidance.
Lead
Myo Maung Maung Swe and Cherry Lim- Centre for Tropical Medicine and Global Health at the University of Oxford
What we did
Using empirical treatment recommendations from the WHO AWaRe book, we developed decision-tree models for children (1 month–12 years) and for adolescents/adults (>12 years). Expected antibiotic use was estimated with Global Point Prevalence Survey (Global-PPS) data from 358 hospitals in 10 countries (Brazil, Guatemala, India, Iran, Mexico, Montenegro, Nigeria, the Philippines, Russia, and Zambia). Models incorporated local disease diagnosis data and country-specific AMR data from the WHO GLASS dashboard, published literature, and the Global Research on Antimicrobial Resistance (GRAM) study. We also performed sensitivity analyses by varying the proportion of severe cases to explore the range of expected antibiotic use across populations with differing disease severity. Modelled estimates of expected antibiotic use were compared with reported use across those 10 countries.
Key learnings
The findings indicate that, in most countries, the observed use of “Watch” group antibiotics exceeded the levels expected under full adherence to WHO AWaRe guidance.
Outputs
Funder
The Wellcome Trust