WHO AWaRe Antibiotic Classification

The WHO AWaRe classification groups antibiotics according to their therapeutic role and potential contribution to antimicrobial resistance. Its purpose is to support antimicrobial stewardship by improving access to appropriate antibiotics, discouraging unnecessary use of higher-risk agents, and preserving last-resort treatments.

The three groups

Introduced through the WHO Model List of Essential Medicines in 2017, the classification assigns antibiotics to three stewardship groups.

• Access antibiotics are generally effective against commonly encountered susceptible pathogens and have lower resistance potential; they should be widely available as appropriate first or second treatment choices.
• Watch antibiotics have higher resistance potential and must be priority targets for monitoring and stewardship, with use limited to appropriate clinical indications.
• Reserve antibiotics are last-resort options for suspected or confirmed infections caused by multidrug-resistant organisms, particularly when alternatives have failed or are unsuitable.

Public health purpose

AWaRe addresses both inadequate access to effective treatment and inappropriate antibiotic use, which accelerates antimicrobial resistance.

• It provides a common framework for monitoring antibiotic consumption across hospitals, regions and countries.
• It helps treatment guidelines, procurement systems and stewardship programmes favour Access-group antibiotics where clinically appropriate.
• It seeks to reduce unnecessary reliance on Watch antibiotics and preserve the effectiveness of Reserve antibiotics.
• It complements, rather than replaces, clinical diagnosis, microbiological testing and local resistance information.

How UPSC asks this