Ground level utility of Access, Watch, Reserve classification: Insights from a tertiary care center in North India

Table 1 Descriptive data representing the antibiotic usage patterns categorized according to the designation of prescriber, department, outpatient vs inpatient and AWaRe classification

Category	Counts	% of total
Total number of patients	123
Total prescriptions	123
No. of different antibiotics used	27
Most common antibiotic	Metronidazole	19
Designation
Senior resident	42	18.7
Junior resident	162	72.0
Consultant	21	9.3
OPD/IPD
OPD	55	24.6
IPD	169	75.4
Department
Medicine	112	49.6
Surgery	114	50.4
WHO AWaRe classification
Access	140	57.61
Watch	93	38.27
Reserve	10	4.11
	Antibiotics used in a patient	Duration of antibiotics
Mean	1.84	6.63
Median	2	6.00
Standard deviation	0.833	3.83
Minimum	1	1.00
Maximum	5	19.0

Second half of the table represents the descriptive analysis of antibiotics used and duration of individual antibiotics. OPD: Outpatient; IPD: Inpatient; WHO: World Health Organization.

Table 2 Representation of knowledge of World Health Organization Access, Watch, Reserve classification among healthcare professionals

Category	Counts	% of total
Position
Junior resident	65	69.9
Senior resident	24	25.8
Faculty	4	4.3
Do you know about WHO AWaRe classification
No details	22	23.7
Yes	31	33.3
Never heard	21	22.6
Little Idea	19	20.4
How did you hear about AWaRe?
The internet	29	31.2
The WHO website	10	10.8
The antimicrobial policy of our institution	14	15.1
Other sources	19	20.4
No idea about it	21	22.6

AWaRe: Access, Watch, Reserve; WHO: World Health Organization.

Table 3 Knowledge (Score) on World Health Organization Access, Watch, Reserve classification

	Total score	Junior resident (n = 21)	Senior resident (n = 9)	Consultant (n = 3)	Medicine (n = 24)	Surgery (n = 9)
n	33	-	-	-	-	-
Mean	3.91	3.81	4.22	3.67	3.79	4.22
Standard deviation	2.17	2.25	2.33	1.53	2.08	2.49
Minimum	1	1	1	2	1	1
Maximum	8	8	8	5	8	8

WHO: World Health Organization.

Table 4 Representation of awareness towards World Health Organization Access, Watch, Reserve classification among healthcare professionals

Statement	False	True	No idea	n
Emergence of Antimicrobial Resistance is inevitable	24	68	1	93
It will result in inability to treat serious infections	13	80	0	93
Lengthier hospital stays will be a result	35	58	0	93
Success of chemotherapy and major surgery will be hampered	50	43	0	93
Cost of treatment will be increased	52	41	0	93
MMR and IMR will increase	62	31	0	93

AWaRe: Access, Watch, Reserve; WHO: World Health Organization; MMR: Maternal mortality rate; IMR: Infant Mortality Rate

.

Table 5 Representation of attitude towards World Health Organization Access, Watch, Reserve classification among healthcare professionals

Question	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
Should AWaRe be used in the hospital?	18 (19.4%)	2 (2.2%)	21 (22.6%)	33 (35.5%)	19 (20.4%)
AWaRe reduces adverse effects of inappropriate prescription	12 (12.9%)	5 (5.4%)	25 (26.9%)	32 (34.4%)	19 (20.4%)
AWaRe threatens a clinician's autonomy	9 (9.7%)	35 (37.6%)	35 (37.6%)	11 (11.8%)	3 (3.2%)
It can delay treatment	16 (17.2%)	37 (39.8%)	28 (30.1%)	8 (8.6%)	4 (4.3%)

AWaRe: Access, Watch, Reserve.