The WHO AWaRe classification sorts antibiotics into Access (narrow-spectrum first choices, such as amoxicillin, nitrofurantoin and doxycycline), Watch (broader agents with higher resistance potential, such as most cephalosporins beyond the first generation, fluoroquinolones, macrolides and carbapenems), and Reserve (last-resort agents). WHO's target is for most use to come from Access.
The WHO AWaRe Antibiotic Book gives first-choice recommendations for common infections. Asking whether an Access agent would do is the fastest stewardship step available in a busy clinic.
- Check whether an Access antibiotic would treat the infection before choosing a Watch agent
- Avoid fluoroquinolones and third-generation cephalosporins for uncomplicated community infections where an Access option exists
- Use the WHO AWaRe Antibiotic Book for first-choice options and durations
- Record why a Watch or Reserve agent was chosen
Why it matters
One question at the point of prescribing does more for resistance than most policies.
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