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Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

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收录情况： ◇ SCIE

作者：
Hsia, Yingfen[1] * ; Lee, Brian R.[2] ; Versporten, Ann[3] ; Yang, Yonghong[4,5] ; Bielicki, Julia[1,6] ; Jackson, Charlotte[1] ; Newland, Jason[7] ; Goossens, Herman[3] ; Magrini, Nicola[8] ; Sharland, Mike[1] ; Teston, L.[9] ; Cheung, K.[10] ; Koning, S.[11] ; Grimwood, K.[12] ; Cross, J.[12] ; da Silva, A.[13,14] ; Benadof, D.[15] ; Zhang, W. S.[16] ; Zhao, W.[17] ; Liu, G.[18] ; Shen, K. L.[18] ; Yao, K. H.[18] ; Zheng, Y. J.[19] ; Deng, J. K.[19] ; Zhang, J. S.[19] ; Wang, Y.[20] ; Jiang, X. Y.[20] ; Tian, D. Y.[21] ; Jing, C. M.[21] ; Wang, L. J.[22] ; Cao, S. C.[22] ; Wu, L. J.[23] ; Chen, X.[23] ; Ding, M. J.[24] ; Zhang, L.[24] ; Lin, L.[25] ; Yang, J. H.[25] ; Cao, Q.[26] ; Wang, W.[26] ; Li, J. P.[27] ; Tang, L. F.[27] ; Liu, J.[28] ; Wang, P.[28] ; Qian, J.[29] ; Zhu, C. M.[29] ; Lu, G.[30] ; Deng, Q. L.[30] ; Mu, X. P.[31] ; Zhao, C. A.[31] ; Dong, X. Y.[32] ; Zhang, H.[32] ; Li, C. Y.[33] ; Li, W.[33] ; Saxen, H.[34] ; Kekomaki, S.[34] ; Hufnagel, M.[35,113] ; Rippberger, B.[35] ; Knuf, M.[36] ; Nikolic, P.[36] ; Huebner, J.[37] ; Kreitmeyer, K.[37] ; Behrends, U.[38] ; Rieber, N.[38] ; Renk, H.[39] ; Spyridis, N.[40] ; Tsolia, M.[40] ; Papaevangelous, V[41] ; Gkentzi, D.[42] ; Syrogiannopoulos, G.[43] ; Kaffe, K.[43] ; Roilides, E.[44,115] ; Pitsava, G.[44] ; Papadimitriou, E.[44] ; Iosifidis, E.[44,115] ; Gandra, S.[45] ; Laxminarayan, R.[45] ; Alvarez-Uria, G.[46] ; Jinka, D.[46] ; Murki, Srinivas[47] ; Kandraju, H.[47] ; Singh, S.[48] ; Vasudevan, A. K.[48] ; Kanithi, R.[49] ; Akula, A.[49] ; Chikkappa, A.[50] ; Tunga, O.[50] ; Subramanian, S.[51] ; Sharma, A.[52] ; Dharmapalan, D.[53] ; Ashkenazi-Hoffnung, L.[54] ; Ashkenazi, S.[54] ; Esposito, S.[55] ; Tagliabue, C.[56] ; Tersigni, C.[57] ; Galli, L.[57] ; D'Argenio, P.[58] ; Pansa, P.[59] ; Duse, M.[59] ; Horikoshi, Y.[60] ; Fukuoka, K.[60] ; Jimenez, R.[61] ; Ojeda, K.[61] ; Okokon, I[62] ; Mahmood, H.[63] ; Gowin, E.[64] ; Slowinska-Jarzabek, B.[64] ; Majda-Stanislawska, E.[65] ; Sicinska, J.[65] ; Chan, S. M.[66] ; Chang, A.[66] ; Rozic, M.[67] ; Premru, M.[67] ; Finlayson, H.[68,145] ; Whitelaw, A.[68] ; Rabie, H.[68] ; Dramowski, A.[68] ; O'Connell, N.[69] ; Epalza, C.[70] ; Rojo-Conejo, Pablo[70] ; Martinon Torres, Federico[71] ; Justicia, Antonio[71] ; Jian, V[72] ; Cheng, C. L.[72] ; Lumbiganon, P.[73] ; Paopongsawan, P.[73] ; Puthanakit, T.[74] ; Anugulruengkitt, S.[74] ; Yarci, E.[75] ; Doerholt, K.[76] ; Vazouras, K.[76] ; Bamford, A.[77] ; Irwin, A.[77] ; Drysdale, S. B.[78] ; Collett-White, F.[78] ; Harkensee, C.[79] ; McMaster, P.[80] ; Green, H.[81] ; Rees, S.[81] ; Ledoare, K.[82] ; Chappell, F.[82] ; Jacqueline, D.[83] ; Hackett, S.[83] ; Vergnano, S.[84] ; Praveen, S.[85] ; Herberg, J.[85] ; Speirs, L.[86] ; Moriarty, Paul[86] ; Lacej, D.[87] ; Hoxha, I[88] ; Cornistein, W.[89,90] ; Quiros, R.[91] ; Hojman, M.[92] ; Del Castillo, M.[93] ; Ghazaryan, L.[94] ; AlSalman, J.[95] ; Konopnicki, D.[96] ; Pierard, D.[97] ; Holemans, X.[98] ; Schelstraete, P.[99] ; Firre, E.[100] ; Van Herendael, B.[101] ; Dedeic-Ljubovic, A.[102] ; Pignatari, A.[103] ; Sabuda, D.[104] ; Carvajal, C.[105] ; Alvaro, R.[105] ; Labarca, J.[105] ; Solano, A.[106] ; Ramirez, C.[107] ; Marekovic, I[108] ; Horvatic, J.[108] ; Pristas, I[109] ; Marshall, E.[110] ; Pagava, K.[111] ; Korinteli, I[111] ; Neubert, A.[112] ; Enimil, A.[114] ; Frimpong, J. A.[114] ; Soltani, J.[116] ; Fitzgerald, D.[117] ; Kasahara, K.[118] ; Gu, Y.[119] ; Okinaka, K.[120] ; Kunishima, H.[121] ; Elhajji, F. Darwish[122] ; Alshehri, M.[123] ; Raka, L.[124,125] ; Kambaralieva, B.[126] ; Sviestina, I[127,128] ; Burokiene, S.[129] ; Usonis, V[129] ; Shaqiri, E.[130] ; Zarb, P.[131] ; Markovic, G.[132] ; Simovic, S.[133] ; Nwajiobi-Princewil, P.[134] ; Iregbu, K.[135] ; Aboderin, A.[136] ; Oduyebo, O.[137] ; Olayinka, A.[138] ; McCorry, A.[139] ; McCullagh, B.[140] ; Gormley, C.[141] ; Rachina, S.[142] ; Carevic, B.[143] ; Chen, H. H.[66] ; Ling, M. L.[144] ; Terol Barrero, P.[146] ; Buijtels, P.[147] ; van Elzakker, E.[148] ; Thompson, S.[149] ; Cooper, M.[150] ; Rios, E.[151] ; Hudson, M.[152] ; Greer, N.[153] ; Gessner-Wharton, M.[154] ; Gawrys, G.[155] ;
机构： [1]St Georges Univ London, Paediat Infect Dis Res Grp, Inst Infect & Immun, London, England; [2]Childrens Mercy Kansas City, Kansas City, MO USA; [3]Univ Antwerp, Lab Med Microbiol, Vaccine & Infect Dis Inst VAXINFECTIO, Fac Med & Hlth Sci, Antwerp, Belgium; [4]Capital Med Univ, Lab Microbiol & Immunol, Beijing Childrens Hosp, Beijing, Peoples R China; [5]Shenzhen Childrens Hosp, Dept Internal Med, Shenzhen, Peoples R China; [6]Univ Basel, Paediat Pharmacol & Paediat Infect Dis, Childrens Hosp, Basel, Switzerland; [7]Washington Univ, Dept Pediat, St Louis Childrens Hosp, St Louis, MO 63130 USA; [8]WHO, Dept Essential Med & Hlth Prod, Geneva, Switzerland; [9]Eurekian Gen Hosp, Buenos Aires, DF, Argentina; [10]Monash Childrens Hosp, Melbourne, Vic, Australia; [11]Box Hill Hosp Eastern Hlth, Melbourne, Vic, Australia; [12]Gold Coast Univ Hosp, Southport, Qld, Australia; [13]Prontobaby Childrens Hosp, Rio De Janeiro, Brazil; [14]Hosp Domingos Lourenco, Rio De Janeiro, Brazil; [15]Roberto Rio Childrens Hosp, Santiago, Chile; [16]Tianjin Childrens Hosp, Tianjin, Peoples R China; [17]Shandong Univ, Jinan, Shandong, Peoples R China; [18]Capital Med Univ, Beijing Childrens Hosp, Beijing, Peoples R China; [19]Shenzhen Childrens Hosp, Shenzhen, Peoples R China; [20]Fudan Univ, Pediat Hosp, Shanghai, Peoples R China; [21]Chongqing Childrens Hosp, Chongqing, Peoples R China; [22]Xian Childrens Hosp, Xian, Shaanxi, Peoples R China; [23]Shenzhen Baoan Women & Childrens Hosp, Shenzhen, Peoples R China; [24]Jinan Childrens Hosp, Jinan, Shandong, Peoples R China; [25]Wenzhou Med Univ, Yuying Childrens Hosp, Wenzhou, Peoples R China; [26]Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Shanghai, Peoples R China; [27]Zhejiang Univ, Sch Med, Childrens Hosp, Hangzhou, Zhejiang, Peoples R China; [28]Capital Med Univ, Beijing Obstet & Gynaecol Hosp, Beijing, Peoples R China; [29]Capital Inst Paediat, Beijing, Peoples R China; [30]Guangzhou Women & Childrens Med Ctr, Zhujiang, Peoples R China; [31]Guangdong Prov Women & Childrens Hlth Care Hosp, Shenzhen, Peoples R China; [32]Shanghai Childrens Hosp, Shanghai, Peoples R China; [33]Jilin Univ, Hosp 1, Changchun, Jilin, Peoples R China; [34]Univ Helsinki, Childrens Hosp, Helsinki, Finland; [35]Univ Freiburg, Univ Med Ctr, Med Fac, Freiburg, Germany; [36]Childrens Hosp Wiesbaden, Wiesbaden, Germany; [37]Ludwig Maximilians Univ Munchen, Munich, Germany; [38]Tech Univ Hosp Munich, Munich, Germany; [39]Univ Childrens Hosp Tubingen, Tubingen, Germany; [40]P & A Kyrialcou Childrens Hosp Athens, Athens, Greece; [41]Univ Gen Hosp Attikon, Athens, Greece; [42]Univ Hosp Patras, Patras, Greece; [43]Univ Thessaly, Larisa, Greece; [44]Hippokrateion Hosp, Thessaloniki, Greece; [45]Ctr Dis Dynam Econ & Policy, New Delhi, India; [46]Rural Dev Trust Hosp, Bathalapalli, Andhra Pradesh, India; [47]Fernandez Hosp, Hyderabad, India; [48]Amrita Inst Med Sci, Kochi, Kerala, India; [49]Sowmya Childrens Hosp, Hyderabad, India; [50]Rural Dev Trust Hosp, Kalyanadurgam, India; [51]Paramitha Childrens Hosp, Hyderabad, India; [52]Fortis Hosp, Mohali, India; [53]Dr Yewale Multispecialty Hosp Children, Navi Numbai, India; [54]Schneider Childrens Med Ctr, Petah Tiqwa, Israel; [55]Univ Perugia, Perugia, Italy; [56]Univ Milan, Osped Maggiore Policlin, Fdn IRCCS Cagranda, Milan, Italy; [57]Anna Meyer Childrens Univ Hosp, Florence, Italy; [58]Bambino Gesu Pediat Hosp, Rome, Italy; [59]Univ Roma La Sapienza, Rome, Italy; [60]Tokyo Metropolitan Childrens Med Ctr, Tokyo, Japan; [61]Hosp Infantil Mexico Dr Federico Gomez, Mexico City, DF, Mexico; [62]Univ Calabar Teaching Hosp, Calabar, Nigeria; [63]Children Hosp PIMS, Islamabad, Pakistan; [64]St Joseph Childrens Hosp, Poznan, Poland; [65]Med Univ Lodz, Dept Children Infect Dis, Lodz, Poland; [66]Natl Univ Singapore Hosp, Singapore, Singapore; [67]Univ Med Ctr Ljubljana, Dept Infect Dis, Ljubljana, Slovenia; [68]Tygerberg Acad Hosp, Cape Town, South Africa; [69]Khayelitsha Hosp, Cape Town, South Africa; [70]Hosp 12 Octubre, Madrid, Spain; [71]Hosp Clin Univ Santiago de Compostela, Santiago De Compostela, Spain; [72]Natl Cheng Kung Univ, Tainan, Taiwan; [73]Khon Kaen Univ, Khon Kaen, Thailand; [74]Chulalongkorn Univ, Dept Pediat, Bangkok, Thailand; [75]Zekai Tahir Burak Matern Teaching Hosp, Ankara, Turkey; [76]St Georges Univ London, London, England; [77]Great Ormond St Hosp Sick Children, London, England; [78]Oxford Univ Hosp NHS Fdn Trust, Oxford, England; [79]Univ Hosp North Tees, Hardwick, England; [80]Pennine Acute Hosp NHS Trust, Manchester, England; [81]Southampton Childrens Hosp, Southampton, Hants, England; [82]Evelina London Childrens Hosp, Oxford, England; [83]Heartlands Hosp, Birmingham, W Midlands, England; [84]Bristol Royal Children Hosp, Bristol, Avon, England; [85]St Marys Hosp, London, England; [86]Royal Belfast Hosp Sick Children, Belfast, Antrim, North Ireland; [87]Univ Hosp Ctr Mother Theresa, Tirana, Albania; [88]Univ Med Tirana, Dept Pharm, Tirana, Albania; [89]Hosp Cosme Argerich, Buenos Aires, DF, Argentina; [90]Inst FLENI, Buenos Aires, DF, Argentina; [91]Hosp Univ Austral, Buenos Aires, DF, Argentina; [92]Hosp Bernardino Rivadavia, Clin Ios Virreyes, Buenos Aires, DF, Argentina; [93]FLENI, Buenos Aires, DF, Argentina; [94]Sci Ctr Drug & Med Technol Expertise MoH, Yerevan, Armenia; [95]Salmaniya Med Complex, Manama, Bahrain; [96]St Pierre Univ Hosp, Brussels, Belgium; [97]Univ Ziekenhuis Brussel, Brussels, Belgium; [98]Grand Hop Charleroi, Charleroi, Belgium; [99]Ghent Univ Hosp, Ghent, Belgium; [100]CHR Liege, Liege, Belgium; [101]GZA Hosp, Antwerp, Belgium; [102]Clin Ctr Univ Sarajevo, Sarajevo, Bosnia & Herceg; [103]Univ Fed Sao Paulo, Sao Paulo, Brazil; [104]Alberta Hlth Serv, Calgary, AB, Canada; [105]Pontificia Univ Catolica Chile, Dept Infect Dis, Sch Med, Santiago, Chile; [106]Hosp Calderon Guardia, San Jose, Costa Rica; [107]Hosp Mexico, San Jose, Costa Rica; [108]Univ Hosp Ctr Zagreb, Zagreb, Croatia; [109]Univ Hosp Infect Dis, Zagreb, Croatia; [110]Univ Hosp Bristol NHS Fdn Trust, Bristol, Avon, England; [111]Tbilisi State Med Univ, Dept Child & Adolescent Med, Tbilisi, Georgia; [112]Univ Hosp Erlangen, Dept Paediat & Adolescent Med, Erlangen, Germany; [113]Univ Freiburg, Div Pediat Infect Dis & Rheumatol, Dept Paediat & Adolescent Med, Univ Med Ctr,Med Fac, Freiburg, Germany; [114]Komfo Anokye Teaching Hosp, Kumasi, Ghana; [115]Aristotle Univ Thessaloniki, Hippokrat Hosp, Thessaloniki, Greece; [116]Kurdistan Univ Med Sci, Fac Med, Sanandaj, Iran; [117]Natl Matern Hosp, Dublin, Ireland; [118]Nara Med Univ, Kashihara, Nara, Japan; [119]Tohoku Univ Hosp, Sendai, Miyagi, Japan; [120]Natl Canc Ctr, Tokyo, Japan; [121]Tama Municipal Hosp, Kawasaki, Kanagawa, Japan; [122]Appl Sci Private Univ, Fac Phannacy, Amman, Jordan; [123]King Fahad Med City, Childrens Hosp Riyadh, Riyadh, Saudi Arabia; [124]Natl Inst Publ Hlth Kosovo, Prishtina, Kosovo; [125]Univ Prishtina Hasan Prishtina, Prishtina, Kosovo; [126]Tolunok Municipal Hosp, Tokmok, Kyrgyzstan; [127]Univ Childrens Hosp, Riga, Latvia; [128]Univ Latvia, Riga, Latvia; [129]Vilnius Univ, Inst Clin Med, Clin Children Dis, Vilnius, Lithuania; [130]Inst Publ Hlth, Skopje, Macedonia; [131]Mater Dei Hosp, Msida, Malta; [132]Inst Childrens Dis, Podgorica, Montenegro; [133]Hlth Insulance Fund, Podgorica, Montenegro; [134]Natl Hosp, Abuja, Nigeria; [135]Natl Hosp Abuja, Abuja, Nigeria; [136]Obafemi Awolowo Univ, Teaching Hosp Complex, Ife, Nigeria; [137]Lagos Univ Teaching Hosp, Lagos, Nigeria; [138]Ahmadu Bello Univ, Teaching Hosp, Zaria, Nigeria; [139]Southern Hlth & Social Care Trust, Craigavon, North Ireland; [140]South Eastern Hlth & Social Care Trust, Dundonald, North Ireland; [141]Western Hlth & Social Care Trust, Derry, North Ireland; [142]Russian Friendship Univ, Moscow, Russia; [143]Clin Ctr Serbia, Belgrade, Serbia; [144]Singapore Gen Hosp, Singapore, Singapore; [145]Stellenbosch Univ, Dept Paediat & Child Hlth, Cape Town, South Africa; [146]Virgen Macarena Univ Hosp, Seville, Spain; [147]Meander Med Ctr, Amersfoort, Netherlands; [148]Haga Hosp, The Hague, Netherlands; [149]Sheffield Childrens Hosp, Sheffield, S Yorkshire, England; [150]HCA Healthcare, Nashville, TN USA; [151]Healthtrust, Sugar Land, TX USA; [152]Colleton Med Ctr, Walterboro, SC USA; [153]Hosp Corp Amer, Nashville, TN USA; [154]Kingwood Med Ctr, Kingwood, TX USA; [155]Methodist Hosp, San Antonio, TX USA; [156]St Georges Univ London, Paediat Infect Dis Res Grp, London SW17 0RE, England
出处：
DOI： 10.1016/S2214-109X(19)30071-3
ISSN：

摘要：
Background Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. Methods 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Findings Of the 23 572 patients included from 56 countries, 18305 were children (77.7%) and 5267 were neonates (22.3%). Access antibiotic use in children ranged from 7.8% (China) to 61.2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77.3%) and lowest in Finland (23.0%). In neonates, Access antibiotic use was highest in Singapore (100.0%) and lowest in China (24.2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. Interpretation There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

基金：
PENTA Foundation; Sanming Project of Medicine in Shenzhen [SZSM2015120330]; bioMerieux
语种：
外文
高被引：
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2018]版：
大类 | 1 区 医学
小类 | 1 区 公共卫生、环境卫生与职业卫生
最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 公共卫生、环境卫生与职业卫生
JCR分区：
出版当年[2017]版：
Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
最新[2023]版：
Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

影响因子： 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

第一作者：
第一作者机构： [1]St Georges Univ London, Paediat Infect Dis Res Grp, Inst Infect & Immun, London, England;
通讯作者：
通讯机构： [1]St Georges Univ London, Paediat Infect Dis Res Grp, Inst Infect & Immun, London, England; [156]St Georges Univ London, Paediat Infect Dis Res Grp, London SW17 0RE, England
推荐引用方式(GB/T 7714)：
Hsia Yingfen,Lee Brian R.,Versporten Ann,et al.Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries[J].LANCET GLOBAL HEALTH.2019,7(7):E861-E871.doi:10.1016/S2214-109X(19)30071-3.
APA：
Hsia, Yingfen,Lee, Brian R.,Versporten, Ann,Yang, Yonghong,Bielicki, Julia...&Gawrys, G..(2019).Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries.LANCET GLOBAL HEALTH,7,(7)
MLA：
Hsia, Yingfen,et al."Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries".LANCET GLOBAL HEALTH 7..7(2019):E861-E871

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