WHO AWaRe抗生素分類統計與應用

Statistics and Application of the WHO AWaRe Classification of Antibiotics

抗生素抗藥性（Antimicrobial Resistance, AMR）的嚴重性、原因以及世界各國如何因應是全球主要公共衛生問題之一，為推動抗生素合理使用（Antimicrobial Stewardship AMS）是當前最關鍵且有效的解決途徑；惟WHO AWaRe抗生素分類是世界衛生組織（WHO）為改善抗生素的適當使用、對抗抗生素抗藥性（AMR）而制定的一套分類系統；WHO於2017年首次發布，AWaRe分類為Access、Watch、Reserve，在醫療機構臨床實務提供了選擇抗生素的框架，鼓勵在治療一般常見感染時優先選擇「Access」類抗生素，以降低廣泛抗生素濫用和抗藥性的風險，WHO也建議世界各國應將「Access」類抗生素的佔比作為一個核心績效指標，鼓勵將資源投入於確保這些關鍵藥物的可近性和供應，透過限制「Watch」和「Reserve」類藥物的使用；藉由臨床抗生素耗用量至使用WHO AWaRe分類進行管理、再到強化感染管制，是應對抗抗生素抗藥性AMR威脅、落實抗生素合理使用的三位一體策略，進而在「治療病人」和「保護未來抗生素藥效」之間取得平衡。

The severity, causes, and global response to antimicrobial resistance (AMR) constitute one of the major global public health challenges. Promoting antimicrobial stewardship (AMS) is currently the most critical and effective pathway to address this crisis.
The WHO AWaRe Classification of Antibiotics is a system developed by the World Health Organization (WHO) to improve the appropriate use of antibiotics and combat AMR. First published by the WHO in 2017, the AWaRe system categorizes antibiotics into three groups: Access, Watch, and Reserve.
This system provides a practical framework for antibiotic selection in clinical settings and encourages the preferential use of Access group antibiotics for common infections to mitigate the risks associated with widespread antibiotic misuse and resistance. T
he WHO also recommends that countries adopt the proportion of comsumption of Access-group antibiotics as a core performance indicator. This encourages investment in ensuring the accessibility and supply of these critical drugs while restricting the use of Watch and Reserve-group medications.
The combination of monitoring clinical antibiotic consumption using the WHO AWaRe Classification for management, alongside strengthening infection control, forms a three-pronged strategy for tackling the threat of AMR and implementing effective AMS. This strategy ultimately aims to strike a balance between“treating patients”and“preserving the efficacy of future antibiotics.”