AWaRe Antibiotic Classification
Antimicrobial prescribing: NHS Forth Valley
NHS Scotland has adopted the UK AMR National Action Plan Target 4b:
"by 2029, to achieve 70% of total use of antibiotics from the Access category across the human healthcare system."
Local guidelines are compiled and reviewed to ensure appropriate, safe empirical antibiotic therapy is recommended aiming to minimise impact on antimicrobial resistance as much as possible.
Antibiotics are now divided into Access, Watch and Reserve categories in order to promote antimicrobial stewardship in the NHS.
The AWaRe classification is as follows:
| Category | Explanation | Examples (oral only) |
|
ACCESS |
First & second line for empirical treatment of common infection syndromes Cause less toxicity. Lower risk of C difficile infection Less potential for selecting antimicrobial resistance. |
AMOXICILLIN CEFALEXIN CO-TRIMOXAZOLE DOXYCYCLINE FLUCLOXACILLIN FOSFOMYCIN METRONIDAZOLE NITROFURANTOIN PENICILLIN V PIVMECILLINAM TRIMETHOPRIM |
|
WATCH |
Broader spectrum Higher toxicity Higher potential for resistance developing Use should be carefully monitored |
AZITHROMYCIN CEFUROXIME CIPROFLOXACIN CLARITHROMYCIN CLINDAMYCIN CO-AMOXICLAV LEVOFLOXACIN LYMECYCLINE MINOCYCLINE MOXIFLOXACIN |
| RESERVE |
"Last resort" antibiotics Used for highly selected patients (severe/life-threatening infections due to multi-drug-resistant bacteria) Usually on advice from Microbiology / Infectious disease only or if no other antibiotic options available (e.g on microbiology culture report) |
LINEZOLID |