ArticleBulletin of the World Health Organization2021
Progress towards antibiotic use targets in eight high-income countries.
Article in Bulletin of the World Health Organization, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 27 citations in OpenAlex.
- Antimicrobial Consumption and Resistance Dynamics Across Healthcare Level: Global Evidence and Stewardship Implications.Pathogens (Basel, Switzerland) · 2026Review
- Analysis of Antibiotic Consumption Trends and Pathogens' Epidemiological Profile Within a Multidisciplinary Clinical Hospital from Romania.Antibiotics (Basel, Switzerland) · 2026Article
- The trend and potential factors of the longitudinal antimicrobial resistance of Escherichia coli strains in recent decades worldwide.BMC microbiology · 2026Article
- Article
- Impact of a tailored, department-specific antimicrobial stewardship team intervention based on AWaRe guidelines: a single-center, cohort, interrupted-time series study.Journal of pharmaceutical health care and sciences · 2025Article
- Patterns of antimicrobial use in Qatar's hospitals: Results from the first national point prevalence survey.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Article
- Antibiotic Prescription Patterns in the Post-COVID-19 Era in Six European Countries: A Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2025Article
- Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Observational study of antibiotic prescribing patterns by age and sex in primary care in England: why we need to take this variation into account to evaluate antibiotic stewardship and predict AMR variation.JAC-antimicrobial resistance · 2025Article
- Global trends in antibiotic consumption during 2016-2023 and future projections through 2030.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Assessment of antibiotic consumption patterns in hospital and primary healthcare using WHO Access, Watch and Reserve classification (AWaRe) in Sichuan Western China: 2020.Archives of public health = Archives belges de sante publique · 2024Article
- Patterns of community antibiotic use with reference to the AWaRe classification of the World Health Organization.JAC-antimicrobial resistance · 2024Article
- RETRACTED: Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward.Antibiotics (Basel, Switzerland) · 2023Article
- Long-term trend of antibiotic use at public health care institutions in northwest China, 2012-20 -- a case study of Gansu Province.BMC public health · 2023Article
- Article
- Over-Prescription and Overuse of Antimicrobials in the Eastern Mediterranean Region: The Urgent Need for Antimicrobial Stewardship Programs with Access, Watch, and Reserve Adoption.Antibiotics (Basel, Switzerland) · 2022Article
- Analysis of antibiotic use patterns in Danish hospitals 2015-2021 using an adapted version of the who aware classification.BMJ open quality · 2022Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 5 countries.
Funding
Abstract
objectiveTo compare antibiotic sales in eight high-income countries using the 2019 World Health Organization (WHO) Access, Watch and Reserve (AWaRe) classification and the target of 60% consumption of Access category antibiotics.
methodsWe analysed data from a commercial database of sales of systemic antibiotics in France, Germany, Italy, Japan, Spain, Switzerland, United Kingdom of Great Britain and Northern Ireland, and United States of America over the years 2013-2018. We classified antibiotics according to the 2019 AWaRe categories: Access, Watch, Reserve and Not Recommended. We measured antibiotic sales per capita in standard units (SU) per capita and calculated Access group sales as a percentage of total antibiotic sales.
findingsIn 2018, per capita antibiotic sales ranged from 7.4 SU (Switzerland) to 20.0 SU (France); median sales of Access group antibiotics were 10.9 SU per capita (range: 3.5-15.0). Per capita sales declined moderately over 2013-2018. The median percentage of Access group antibiotics was 68% (range: 22-77 %); the Access group proportion increased in most countries between 2013 and 2018. Five countries exceeded the 60% target; two countries narrowly missed it (> 55% in Germany and Italy). Sales of Access antibiotics in Japan were low (22%), driven by relatively high sales of oral cephalosporins and macrolides.
conclusionWe have identified changes to prescribing that could allow countries to achieve the WHO target. The 60% Access group target provides a framework to inform national antibiotic policies and could be complemented by absolute measures and more ambitious values in specific settings.
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