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The WHO AWaRe Classification is a method to categorize antibiotics into three groups in an effort to improve appropriate antibiotic use. [1] [2] The classification is based, in part, on the risk of developing antibiotic resistance and their importance to medicine. [1] [3] It does not reflect effectiveness or strength. [4]
Effective January 1, 2020, the Joint Commission antimicrobial stewardship requirements were expanded to outpatient health care organizations as well. [21] In 2018, a survey of AMS programs in the US showed each 0.50 increase in pharmacist and physician full-time equivalent support predicted a roughly 1.5-fold increase in the programs effectiveness.
Narrow-spectrum antibiotics have low propensity to induce bacterial resistance and are less likely to disrupt the microbiome (normal microflora). [3] On the other hand, indiscriminate use of broad-spectrum antibiotics may not only induce the development of bacterial resistance and promote the emergency of multidrug-resistant organisms, but also cause off-target effects due to dysbiosis.
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Antibiotics with less reliable but occasional (depending on isolate and subspecies) activity: occasionally penicillins including penicillin, ampicillin and ampicillin-sulbactam, amoxicillin and amoxicillin-clavulnate, and piperacillin-tazobactam (not all vancomycin-resistant Enterococcus isolates are resistant to penicillin and ampicillin)
Antibiotics can cause severe reactions and add significantly to the cost of care. [21] In the United States, antibiotics and anti-infectives are the leading cause of adverse effect from drugs. In a study of 32 States in 2011, antibiotics and anti-infectives accounted for nearly 24 percent of ADEs that were present on admission, and 28 percent ...