重新考虑世卫组织的AWaRe分类:需要更详细的指导
Shinya Tsuzuki1,2,3, Ryuji Koizumi2, Kensuke Aoyagi2
1Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan.
EClinicalMedicine
|December 9, 2025
概括
世界卫生组织对抗生素使用的访问,观察和储备 (AWaRe) 分类有局限性. 全球目标可能不反映区域需求,处方时间会影响结果,可能误导管理评估.
科学领域:
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
背景情况:
- 世界卫生组织的获取,观察和储备 (AWaRe) 分类是评估全球抗菌药物使用 (AMU) 质量的关键工具.
- 它旨在促进适当的抗生素利用,并作为全球抗生素管理计划的基准.
研究的目的:
- 批判性地评估AWaRe分类系统的局限性.
- 调查流行病学理由,区域疾病模式,药物分类不一致性和处方期限等因素如何影响AWaRe框架,以日本为案例研究.
主要方法:
- 分析AWaRe分类系统的结构和目标.
- 对来自日本的抗微生物药物使用数据的案例研究检查.
- 评估处方时间对AWaRe类别百分比的影响.
主要成果:
- 全球AWaRe目标,特别是"准入"抗生素 (60% - 70%),缺乏强有力的流行病学理由,可能与区域疾病流行率不一致.
- 药物分类中的不一致性和处方时间的未监控变量可以显著扭曲Access类别的百分比.
- 目前的AMU监测方法,通常省略处方时间,使全球AWaRe比较具有潜在误导性.
结论:
- AWaRe分类系统需要仔细重新评估,以确保其全球目标和指标准确地反映区域现实和疾病模式.
- 抗生素药物管理监测方法需要改进,可能包括处方持续时间监测,以便更有意义地评估抗生素管理工作.
- 为了准确的全球比较和全球有效的抗微生物药物管理,需要修改方法.
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