Evidence map›Paper›PMID 39422368›Full record

ReviewThe Journal of antimicrobial chemotherapy2024

Identifying AWaRe indicators for appropriate antibiotic use: a narrative review.

Elisa Funiciello, Giulia Lorenzetti, Aislinn Cook, Jan Goelen, Catrin E Moore, Stephen M Campbell, Brian Godman, Deborah Tong, Benedikt Huttner, Pem Chuki and 1 more

Abstract readReview
In one paragraph

Review in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Elisa FunicielloCentre for Neonatal and Paediatric Infection, St. George's University of London, London SW17 0RE, UK.ORCID 0000-0001-7042-881X
Giulia LorenzettiCentre for Neonatal and Paediatric Infection, St. George's University of London, London SW17 0RE, UK.
Aislinn CookCentre for Neonatal and Paediatric Infection, St. George's University of London, London SW17 0RE, UK.ORCID 0000-0002-9189-7815
Jan GoelenCentre for Neonatal and Paediatric Infection, St. George's University of London, London SW17 0RE, UK.
Catrin E MooreCentre for Neonatal and Paediatric Infection, St. George's University of London, London SW17 0RE, UK.
Stephen M CampbellSchool of Health Sciences, University of Manchester, Manchester M13 9PL, UK.
Brian GodmanSchool of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa.ORCID 0000-0001-6539-6972
Deborah TongDepartment of Surveillance, Prevention and Control, Division of Antimicrobial Resistance, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland.
Benedikt HuttnerDepartment of Health Products Policy and Standards, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland.
Pem ChukiAntimicrobial Stewardship Unit, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
Michael SharlandCentre for Neonatal and Paediatric Infection, St. George's University of London, London SW17 0RE, UK.

Funding

Wellcome TrustWellcome Trust 222051/Z/20/ZWorld Health Organization 001
6 · The paper itself

Abstract

introductionQuality indicators (QIs) are widely used tools for antibiotic stewardship programmes. The Access, Watch, Reserve (AWaRe) system has been developed by the WHO to classify antibiotics based on their spectrum of activity and potential selection of antibiotic resistance. This review aimed to identify existing indicators for optimal antibiotic use to inform the development of future AWaRe QIs.

methodsA literature search was performed in PubMed. We included articles describing QIs for hospital and primary healthcare antibiotic use. We extracted information about (i) the type of infection; (ii) setting; (iii) target for quality assessment; and (iv) methodology used for the development. We then identified the indicators that reflected the guidance provided in the AWaRe system.

resultsA total of 773 indicators for antibiotic use were identified. The management of health services and/or workers, the consumption of antibiotics, and antibiotic prescribing/dispensing were the principal targets for quality assessment. There was a similar distribution of indicators across primary and secondary care. For infection-specific indicators, about 50% focused on respiratory tract infections. Only a few QIs included information on review treatment or microbiological investigations. Although only 8 (1%) indicators directly cited the AWaRe system in the wording of the indicators, 445 (57.6%) indicators reflected the guidance provided in the AWaRe book.

conclusionsA high number of indicators for appropriate antibiotic use have been developed. However, few are currently based directly on the WHO AWaRe system. There is a clear need to develop globally applicable AWaRe based indicators that can be integrated into antibiotic stewardship programmes.

Indexed as

Anti-Bacterial AgentsAntimicrobial StewardshipQuality Indicators, Health CareDrug UtilizationHumansPrimary Health CareRespiratory Tract InfectionsAnti-Bacterial Agents

Identifiers

PMID39422368
PMCPMC11638856

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.