[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-407248-105":59,"doc-detail-407248-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","perspectives-who-definitions-for-reserve-antibiotics","Perspectives - WHO definitions for reserve antibiotics","","Examines how the WHO Access, Watch, Reserve (AWaRe) antibiotic classification connects to essential medicines and national prescribing lists, and explains the 2019 definition of reserve antibiotics as last-resort options for inpatients with confirmed or suspected life-threatening infections from multidrug-resistant bacteria. Highlights that WHO reserve inclusion criteria rely on “proven activity” against critical or high-priority pathogens, yet evidence levels and clinical exclusivity are unclear. Notes limited high-quality data for empiric reserve use and discusses implications for stewardship, surveillance, and antibiotic resistance, including suggested targeted revisions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/perspectives-who-definitions-for-reserve-antibiotics/407248/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/perspectives-who-definitions-for-reserve-antibiotics/407248.png","ImageObject",300,407,{"name":92,"@type":93},"Hazel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How does the WHO AWaRe classification relate to essential medicines and national lists?","Question",{"text":113,"@type":114},"AWaRe is closely linked to the essential medicines concept, and WHO Model lists inform national essential medicines lists. These national lists are used as a fundamental strategy to ensure effective use of constrained healthcare resources.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What are “reserve antibiotics” under the WHO definition?",{"text":118,"@type":114},"Since 2019, reserve antibiotics are last-resort antibiotics intended only for inpatients with confirmed or suspected life-threatening infections due to multidrug-resistant (MDR) bacteria. They should be used only after other therapeutic alternatives have failed or are unsuitable.",{"name":120,"@type":111,"acceptedAnswer":121},"What limitations are discussed regarding the WHO reserve antibiotic inclusion criteria?",{"text":122,"@type":114},"The text states that the evidence level needed to show activity against priority pathogens is unclear, and that priority-pathogen infections may not always require reserve antibiotics. It also notes that the WHO priority pathogens list was originally intended to guide antibiotic R&D rather than essential medicines list decisions.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},407248,1790792482,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":39,"preview_page_count":4},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","Perspectives  \nWHO definitions for reserve antibiotics  \nVeronica Zanichelli,a Jessica Bartoszko,b Benedikt Huttner,c Mark Loeb,b Nicola Magrini,d Marc Mendelson,e Mike Sharland,f Deborah Tong,c Loice Achieng Ombajog & Lorenzo Mojaa  \nThe World Health Organization (WHO) Access, Watch, Reserve (AWaRe) classification of antibiotics is closely linked to the essential medicines concept and the WHO Model lists of essential medicines, which inform national essential medicines lists. 1,2 These national lists are a fundamental strategy in healthcare systems to ensure effective use of constrained resources. Furthermore, by focusing on essential antibiotics, healthcare systems can better meet the health needs of their populations and mitigate the risk of antibiotic resistance.  \nThe AWaRe classification categorizes antibiotics into three groups: Access, Watch or Reserve. This classification, developed in 2017 by the Expert committee on the selection and use of essential medicines, has a twofold objective: prioritizing the most important antibiotics for human health; and supporting stewardship and surveillance activities. 1 As of 2025, WHO has assigned 268 antibiotics used in humans to one of the AWaRe groups.  \nSince 2019, the expert committee defines reserve antibiotics as last-resort antibiotics that are only to be used inpatients with confirmed or suspected life-threatening infection due to multidrug-resistant (MDR) bacteria.3 The AWaRe classification also states that reserve antibiotics should only be used when other therapeutic alternatives have failed or are unsuitable.3 Finally, only reserve antibiotics with proven activity against critical or high priority pathogens identified by the WHO priority pathogens list can qualify for inclusion on the WHO essential medicines list (Box 1) .3 The 2025 WHO essential medicines list includes 50 antibiotics, 10 of which are in the reserve group. A further 20 antibiotics are also currently  \nclassified as reserve for surveillance and stewardship activities, although they are not on the WHO essential medicines list. AWaRe is now the globally accepted method for classifying antibiotics. In 2024, all United Nations (UN) Member States committed to the target that, by 2030, 70% of all human antibiotic use consists of access antibiotics.4 The AWaRe classification is also gaining momentum outside the UN, as evidenced by its use to interpret antibiotic use in research studies,5 surveillance reports by public health agencies6 and the Global antimicrobial resistance and use surveillance system (known as GLASS) .7  \nAWaRe was designed as a dynamic tool, intended to evolve with new evidence and real-world user experience. While its uptake across health systems is encouraging, the current definition and selection criteria for reserve antibiotics in the WHO essential medicines list would benefit from targeted revisions to address existing limitations (Box 2) . The proposed revisions are based on deliberations within the WHO Essential Medicines List Secretariat, the WHO Technical Advisory Group on AWaRe and consultations with other subjectmatter experts.  \nFor essential reserve antibiotics, the statement \"proven activity against critical or high priority pathogens identified by the WHO priority pathogens list\"3 poses problems. First, the level of evidence demonstrating activity against priority pathogens, whether in vitro orin humans, required to include a reserve antibiotic on the WHO essential medicines list is unclear. Furthermore, not all infections caused by these priority pathogens require a reserve antibiotic tobe effectively treated. Watch antibiotics such as meropenem and vancomycin  \nmay be appropriate to treat infections caused by third-generation cephalosporin-resistant Enterobacterales (critical priority) and methicillin-resistant Staphylococcus aureus (high priority), respectively. In other words, the statement \"proven activity against critical or high priority pathogens\"3 is not exclusive to r","cbCaik85Dh0c7JWM","https://ap.wps.com/l/cbCaik85Dh0c7JWM","pdf",724072,"English","# Perspectives\n## AWaRe link to essential medicines and stewardship\n## Definition and eligibility criteria for reserve antibiotics\n## Issues with the “proven activity” requirement\n## Evidence gaps for empiric reserve use and resistance implications","[{\"question\":\"How does the WHO AWaRe classification relate to essential medicines and national lists?\",\"answer\":\"AWaRe is closely linked to the essential medicines concept, and WHO Model lists inform national essential medicines lists. These national lists are used as a fundamental strategy to ensure effective use of constrained healthcare resources.\"},{\"question\":\"What are “reserve antibiotics” under the WHO definition?\",\"answer\":\"Since 2019, reserve antibiotics are last-resort antibiotics intended only for inpatients with confirmed or suspected life-threatening infections due to multidrug-resistant (MDR) bacteria. They should be used only after other therapeutic alternatives have failed or are unsuitable.\"},{\"question\":\"What limitations are discussed regarding the WHO reserve antibiotic inclusion criteria?\",\"answer\":\"The text states that the evidence level needed to show activity against priority pathogens is unclear, and that priority-pathogen infections may not always require reserve antibiotics. It also notes that the WHO priority pathogens list was originally intended to guide antibiotic R\\u0026D rather than essential medicines list decisions.\"}]","Perspectives - WHO definitions for reserve antibiotics | PDF",1790572241]