Classifying antibiotics in the WHO Essential Medicines List for optimal use—be AWaRe
(2018; 3 pages)

The Lancet Infectious Diseases, Volume 18, No. 1, p18–20, January 2018.


Optimising the use of antimicrobials is a key priority of the global strategy to combat antimicrobial resistance.

Revision of the Essential Medicines List (EML) entails complex decisions that assess health outcomes while accounting for feasibility, monitoring, registration, and cost of listed medications. The last complete revision of antibiotics was done in 2001. For the 2017 update on the EML, comprehensive reviews on antibiotic use for specific clinical infections were commissioned by WHO. After assessing the evidence on the most frequent and severe bacterial infections, the Expert Committee identified a few options as first-choice and second-choice antibiotics for each type of infection and categorised antibiotics into three groups, with the goals of improved access and clinical outcomes, reduced potential for development of antimicrobial resistance, and preserved effectiveness of the so-called last-resort antibiotics (figure).

To improve access to effective therapy, the Committee first designated specific Access antibiotics. Antibiotics selected for the Access group were those listed as first and second choices for the empirical treatment of 21 common or severe clinical syndromes.

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