5.1 Global-scale measures
- Not to be used as preventive treatment applied in feed or water in the absence of clinical signs of illness in the animal(s) to be treated.
- Not to be used as first line treatment unless justified. When used as a second line treatment, it should ideally be based on the results of bacteriological tests.
- Extra label/off-label use should be limited and reserved for instances where no alternatives are available. Such use should be in agreement with the national legislation in force.
The WHO classifies antibiotics for human use into three stewardship groups: Access, Watch and Reserve (AWaRe), as described below. The majority of 3GCs, including ceftriaxone, are in the Watch group, which includes most of the highest priority critically important antimicrobials for human medicine. The WHO recommends that ‘antibiotics in the “Watch” group should be prioritized as key targets of stewardship programs and antimicrobial use monitoring’.can be accessed from the WHO website (WHO, 2019c).
The WHO’s AWaRe classification
Access antibiotics ‘have activity against a wide range of commonly encountered susceptible pathogens while also showing lower resistance potential than antibiotics in the other groups.’
Watch antibiotics ‘have higher resistance potential and include most of the highest priority agents among the critically important antimicrobials for human medicine and/or antibiotics that are at relatively high risk of selection of bacterial resistance. Antibiotics in the Watch group should be prioritized as key targets of stewardship programs and monitoring.’
Reserve antibiotics ‘include antibiotics and antibiotic classes that should be reserved for treatment of confirmed or suspected infections due to multi-drug-resistant organisms. Antibiotics in the Reserve group should be treated as “last resort” options.’