Struggles of Stewardship

In an effort to monitor antibiotic use and improve stewardship, WHO created the AWaRe tool in 2017 that divides the drugs into 3 categories: Access, Watch, and Reserve, CIDRAP reports.
 
A new Lancet Infectious Diseases analysis based on sales data lays bare the persistent challenges of maintaining this stewardship worldwide. The study found that global use of “Watch” antibiotics—broader spectrum drugs with a higher potential for resistance—rose a whopping 90.9% from 2000–2015.
 
In low- and middle-income countries, that figure was 165%—nearly 6X the increase in high-income countries.
 
One issue is that LMICs are “using antibiotics, in essence, as a substitute for investment in public health to reduce transmission of disease,” said lead author Eili Klein.

But in LMICs, those alarming numbers also exist alongside a lack of access to antibiotics for those who need them.