AWaRe | 20 Jun 2019

The World Health Organization (WHO) in its global campaign against antibiotics has launched a new online tool called AWaRe.

The campaign aims to achieve a 60% increase in the use of antibiotics under the Access group — cheap, ‘narrow-spectrum’ drugs (that target a specific microorganism rather than several) and also lower the risk of resistance.

The AWaRe tool was developed by the WHO Essential Medicines List to contain rising resistance and make antibiotic use safer and more effective by providing guidelines (over the effective use of antibiotics) to the policy-makers and health workers.
It classifies antibiotics into three groups:
- Access— antibiotics used to treat the most common and serious infections.
- Watch— antibiotics available at all times in the healthcare system.
- Reserve— antibiotics to be used sparingly or preserved and used only as a last resort.

By classifying antibiotics into three distinct groups, and advising on when to use them, AWaRe makes it easier for policy-makers, prescribers and health workers to select the right antibiotic at the right time, and to protect endangered antibiotics.

With the emergence of infections that are untreatable by all classes of antibiotics, antimicrobial resistance is turning into an invisible pandemic and is estimated to kill 50 million worldwide and 10 million in India (by 2050).
According to a report by the International Coordination Group on Antimicrobial Resistance, Antimicrobial resistance is a global health and development threat that continues to escalate globally and threatens to undo a century of medical progress.
It is estimated that more than 50% of antibiotics in many countries are used inappropriately, such as for treatment of viruses (when they only treat bacterial infections) or use of the wrong (broader spectrum) antibiotic, thus contributing to the spread of antimicrobial resistance.

One of the most pressing concerns is the spread of resistant gram-negative bacteria, including Acinetobacter, Escherichia coli and Klebsiella pneumoniae.
- As these bacteria, which are commonly seen in hospitalized patients, cause infections like pneumonia, bloodstream infections, wound or surgical site infections and meningitis.
Although over 100 countries have put in place national plans to tackle antimicrobial resistance, only about one-fifth of those plans are funded and implemented.
Antibiotic resistance (when antibiotics stop working effectively) increases health expenditure and makes accessibility and affordability of medicines an expensive affair.

Gram-Negative Bacteria

Bacteria are classified into two groups—Gram-positive or Gram-negative—depending on whether they retain a specific stain color.
Gram-positive bacteria retain a purple-colored stain, while Gram-negative bacteria appear pinkish or red.
Several species of gram negative bacteria including Escherichia coli, are common causes of foodborne disease and Vibrio cholerae—the bacteria responsible for cholera—is a waterborne pathogen.
Gram-negative bacteria can also cause respiratory infections, such as certain types of pneumonia, and sexually transmitted diseases, including gonorrhea.