[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$fxLN3MUwXCdr5RPjwZYIDpOj8CHyjOmngWTgoKXPtZbg":3,"$fB20xiCBRrU51kZ3aFRsQP3luQ1PXKG2JX5NeGLkJhJY":32,"$f3Ft0rKFJHppdzE-vuveecxx1BUcg9iOlMLtyzf_MJDg":48},[4,8,12,16,20,24,28],{"title":5,"slug":6,"path":7},"About Microbeonline.com","about-microbeonline-com","\u002Fabout-microbeonline-com\u002F",{"title":9,"slug":10,"path":11},"About Me","about-me","\u002Fabout-microbeonline-com\u002Fabout-me\u002F",{"title":13,"slug":14,"path":15},"Advertise with Us","advertise-us","\u002Fadvertise-us\u002F",{"title":17,"slug":18,"path":19},"Privacy Policy","privacy-policy","\u002Fprivacy-policy\u002F",{"title":21,"slug":22,"path":23},"Abbreviations","abbreviations","\u002Fabbreviations\u002F",{"title":25,"slug":26,"path":27},"Microbes","microbes","\u002Fmicrobes\u002F",{"title":29,"slug":30,"path":31},"Books","recommended-books","\u002Frecommended-books\u002F",{"type":33,"data":34},"blog",{"slug":35,"title":36,"description":36,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":39,"lastUpdatedDate":40,"draft":41,"category":42,"image":43,"body":44,"faq":45,"tags":46,"related":47},"who-aware-classification-antibiotics","WHO AWaRe Classification of Antibiotics",null,"Acharya Tankeshwar","2021-04-30","2026-07-06",false,"bacteriology","https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002Fwho-aware-classification-of-antibiotics.png","**Access, Watch, Reserve (AWaRe) classification** of antibiotics was developed by **World Health Organization** (WHO) to assist in the development of tools for antibiotic stewardship at local, national, and global levels and to reduce antimicrobial resistance. AwaRe classified antibiotics into different groups to emphasize the importance of their appropriate use.\n\nThis classification is intended to be used as a tool for countries to better support antibiotic monitoring and stewardship activities.\n\n> The aim of the WHO AWaRe antibiotic categorization is to provide a tool to use antibiotics safely and effectively.\n\n## Access group antibiotics\n\n![](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FACCESS-WHO.png)| **Antibiotic** | **Class** | **ATC code** | **Category** | **Listed on EML 2019** |\n| --- | --- | --- | --- | --- |\n| Amikacin | Aminoglycosides | J01GB06 | Access | Yes |\n| Amoxicillin | Penicillins | J01CA04 | Access | Yes |\n| Amoxicillin\u002Fclavulanic Acid | Beta lactam – beta lactamase inhibitor | J01CR02 | Access | Yes |\n| Ampicillin | Penicillins | J01CA01 | Access | Yes |\n| Ampicillin\u002Fsulbactam | Beta lactam – beta lactamase inhibitor | J01CR01 | Access | No |\n| Bacampicillin | Penicillins | J01CA06 | Access | No |\n| Benzathine benzylpenicillin | Penicillins | J01CE08 | Access | Yes |\n| Benzylpenicillin | Penicillins | J01CE01 | Access | Yes |\n| Cefacetrile | First-generation cephalosporins | J01DB10 | Access | No |\n| Cefadroxil | First-generation cephalosporins | J01DB05 | Access | No |\n| Cefalexin | First-generation cephalosporins | J01DB01 | Access | Yes |\n| Cefalotin | First-generation cephalosporins | J01DB03 | Access | No |\n| Cefapirin | First-generation cephalosporins | J01DB08 | Access | No |\n| Cefatrizine | First-generation cephalosporins | J01DB07 | Access | No |\n| Cefazedone | First-generation cephalosporins | J01DB06 | Access | No |\n| Cefazolin | First-generation cephalosporins | J01DB04 | Access | Yes |\n| Cefradine | First-generation cephalosporins | J01DB09 | Access | No |\n| Cefroxadine | First-generation cephalosporins | J01DB11 | Access | No |\n| Ceftezole | First-generation cephalosporins | J01DB12 | Access | No |\n| Chloramphenicol | Amphenicols | J01BA01 | Access | Yes |\n| Clindamycin | Lincosamides | J01FF01 | Access | Yes |\n| Clometocillin | Penicillins | J01CE07 | Access | No |\n| Cloxacillin | Penicillins | J01CF02 | Access | Yes |\n| Dicloxacillin | Penicillins | J01CF01 | Access | No |\n| Doxycycline | Tetracyclines | J01AA02 | Access | Yes |\n| Flucloxacillin | Penicillins | J01CF05 | Access | No |\n| Gentamicin | Aminoglycosides | J01GB03 | Access | Yes |\n| Mecillinam | Penicillins | J01CA11 | Access | No |\n| Metronidazole (IV) | Imidazoles | J01XD01 | Access | Yes |\n| Metronidazole (oral) | Imidazoles | P01AB01 | Access | Yes |\n| Nafcillin | Penicillins | J01CF06 | Access | No |\n| Nitrofurantoin | Nitrofurantoin | J01XE01 | Access | Yes |\n| Oxacillin | Penicillins | J01CF04 | Access | No |\n| Penamecillin | Penicillins | J01CE06 | Access | No |\n| Phenoxymethylpenicillin | Penicillins | J01CE02 | Access | Yes |\n| Pivampicillin | Penicillins | J01CA02 | Access | No |\n| Pivmecillinam | Penicillins | J01CA08 | Access | No |\n| Procaine benzylpenicillin | Penicillins | J01CE09 | Access | Yes |\n| Spectinomycin | Aminocyclitols | J01XX04 | Access | Yes |\n| Sulfadiazine\u002Ftrimethoprim | Trimethoprim – sulfonamide combinations | J01EE02 | Access | No |\n| Sulfamethizole\u002Ftrimethoprim | Trimethoprim – sulfonamide combinations | J01EB02 | Access | No |\n| Sulfamethoxazole\u002Ftrimethoprim | Trimethoprim – sulfonamide combinations | J01EE01 | Access | Yes |\n| Sulfametrole\u002Ftrimethoprim | Trimethoprim – sulfonamide combinations | J01EE03 | Access | No |\n| Sulfamoxole\u002Ftrimethoprim | Trimethoprim – sulfonamide combinations | J01EE04 | Access | No |\n| Sultamicillin | Beta lactam – beta lactamase inhibitor | J01CR04 | Access | No |\n| Tetracycline | Tetracyclines | J01AA07 | Access | No |\n| Thiamphenicol | Amphenicols | J01BA02 | Access | No |\n| Trimethoprim | Trimethoprim | J01EA01 | Access | No |\n\nAccess group includes **48 antibiotics** that have activity against a wide range of commonly encountered susceptible pathogens while also showing lower resistance potential than antibiotics in the other groups.\n\nSelected Access group antibiotics are recommended as essential first or second-choice empiric treatment options for infectious syndromes reviewed by the EML Expert Committee and are listed as individual medicines on the Model Lists of Essential Medicines to improve access and promote appropriate use.\n\n## Watch group antibiotics\n\n![](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FWATCH-WHO.png)The Watch group includes **110 antibiotics** that have higher resistance potential and includes most of the highest priority agents among the [Critically Important Antimicrobials for Human Medicine](https:\u002F\u002Fapps.who.int\u002Firis\u002Fbitstream\u002Fhandle\u002F10665\u002F312266\u002F9789241515528-eng.pdf?ua=1) and\u002For antibiotics that are at relatively high risk of selection of bacterial resistance. These medicines should be prioritized as key targets of stewardship programs and monitoring. Selected Watch group antibiotics are recommended as essential first or second-choice empiric treatment options for a limited number of specific infectious syndromes and are listed as individual medicines on the WHO Model Lists of Essential Medicines.\n\n| **Antibiotic** | **Class** | **ATC code** | **Category** | **Listed on EML 2019** |\n| --- | --- | --- | --- | --- |\n| Arbekacin | Aminoglycosides | J01GB12 | Watch | No |\n| Azithromycin | Macrolides | J01FA10 | Watch | Yes |\n| Azlocillin | Penicillins | J01CA09 | Watch | No |\n| Biapenem | Carbapenems | J01DH05 | Watch | No |\n| Carbenicillin | Carboxypenicillins | J01CA03 | Watch | No |\n| Cefaclor | Second-generation cephalosporins | J01DC04 | Watch | No |\n| Cefamandole | Second-generation cephalosporins | J01DC03 | Watch | No |\n| Cefbuperazone | Second-generation cephalosporins | J01DC13 | Watch | No |\n| Cefcapene pivoxil | Third-generation cephalosporins | J01DD17 | Watch | No |\n| Cefdinir | Third-generation cephalosporins | J01DD15 | Watch | No |\n| Cefditoren pivoxil | Third-generation cephalosporins | J01DD16 | Watch | No |\n| Cefepime | Fourth-generation cephalosporins | J01DE01 | Watch | No |\n| Cefetamet pivoxil | Third-generation cephalosporins | J01DD10 | Watch | No |\n| Cefixime | Third-generation cephalosporins | J01DD08 | Watch | Yes |\n| Cefmenoxime | Third-generation cephalosporins | J01DD05 | Watch | No |\n| Cefmetazole | Second-generation cephalosporins | J01DC09 | Watch | No |\n| Cefminox | Second-generation cephalosporins | J01DC12 | Watch | No |\n| Cefodizime | Third-generation cephalosporins | J01DD09 | Watch | No |\n| Cefonicid | Second-generation cephalosporins | J01DC06 | Watch | No |\n| Cefoperazone | Third-generation cephalosporins | J01DD12 | Watch | No |\n| Ceforanide | Second-generation cephalosporins | J01DC11 | Watch | No |\n| Cefoselis | Fourth-generation cephalosporins | to be assigned | Watch | No |\n| Cefotaxime | Third-generation cephalosporins | J01DD01 | Watch | Yes |\n| Cefotetan | Second-generation cephalosporins | J01DC05 | Watch | No |\n| Cefotiam | Second-generation cephalosporins | J01DC07 | Watch | No |\n| Cefotiam hexetil | Second-generation cephalosporins | J01DC07 | Watch | No |\n| Cefoxitin | Second-generation cephalosporins | J01DC01 | Watch | No |\n| Cefozopran | Fourth-generation cephalosporins | J01DE03 | Watch | No |\n| Cefpiramide | Third-generation cephalosporins | J01DD11 | Watch | No |\n| Cefpirome | Fourth-generation cephalosporins | J01DE02 | Watch | No |\n| Cefpodoxime proxetil | Third-generation cephalosporins | J01DD13 | Watch | No |\n| Cefprozil | Second-generation cephalosporins | J01DC10 | Watch | No |\n| Ceftazidime | Third-generation cephalosporins | J01DD02 | Watch | Yes |\n| Cefteram pivoxil | Third-generation cephalosporins | J01DD18 | Watch | No |\n| Ceftibuten | Third-generation cephalosporins | J01DD14 | Watch | No |\n| Ceftizoxime | Third-generation cephalosporins | J01DD07 | Watch | No |\n| Ceftriaxone | Third-generation cephalosporins | J01DD04 | Watch | Yes |\n| Cefuroxime | Second-generation cephalosporins | J01DC02 | Watch | Yes |\n| Chlortetracycline | Tetracyclines | J01AA03 | Watch | No |\n| Ciprofloxacin | Fluoroquinolones | J01MA02 | Watch | Yes |\n| Clarithromycin | Macrolides | J01FA09 | Watch | Yes |\n| Clofoctol | Phenol derivatives | J01XX03 | Watch | No |\n| Delafloxacin | Fluoroquinolones | J01MA23 | Watch | No |\n| Dibekacin | Aminoglycosides | J01GB09 | Watch | No |\n| Dirithromycin | Macrolides | J01FA13 | Watch | No |\n| Doripenem | Carbapenems | J01DH04 | Watch | No |\n| Enoxacin | Fluoroquinolones | J01MA04 | Watch | No |\n| Ertapenem | Carbapenems | J01DH03 | Watch | No |\n| Erythromycin | Macrolides | J01FA01 | Watch | No |\n| Fleroxacin | Fluoroquinolones | J01MA08 | Watch | No |\n| Flomoxef | Second-generation cephalosporins | J01DC14 | Watch | No |\n| Flumequine | Fluoroquinolones | J01MB07 | Watch | No |\n| Fosfomycin (oral) | Phosphonics | J01XX01 | Watch | No |\n| Fusidic Acid | Steroid antibacterials | J01XC01 | Watch | No |\n| Garenoxacin | Fluoroquinolones | J01MA19 | Watch | No |\n| Gatifloxacin | Fluoroquinolones | J01MA16 | Watch | No |\n| Gemifloxacin | Fluoroquinolones | J01MA15 | Watch | No |\n| Imipenem\u002Fcilastatin | Carbapenems | J01DH51 | Watch | No |\n| Isepamicin | Aminoglycosides | J01GB11 | Watch | No |\n| Josamycin | Macrolides | J01FA07 | Watch | No |\n| Kanamycin | Aminoglycosides | J01GB04 | Watch | No |\n| Latamoxef | Third-generation cephalosporins | J01DD06 | Watch | No |\n| Levofloxacin | Fluoroquinolones | J01MA12 | Watch | No |\n| Lincomycin | Macrolides | J01FF02 | Watch | No |\n| Lomefloxacin | Fluoroquinolones | J01MA07 | Watch | No |\n| Lymecycline | Tetracyclines | J01AA04 | Watch | No |\n| Meropenem | Carbapenems | J01DH02 | Watch | Yes |\n| Metacycline | Tetracyclines | J01AA05 | Watch | No |\n| Mezlocillin | Penicillins | J01CA10 | Watch | No |\n| Micronomicin | Aminoglycosides | to be assigned | Watch | No |\n| Midecamycin | Macrolides | J01FA03 | Watch | No |\n| Minocycline (oral) | Tetracyclines | J01AA08 | Watch | No |\n| Moxifloxacin | Fluoroquinolones | J01MA14 | Watch | No |\n| Neomycin | Aminoglycosides | J01GB05 | Watch | No |\n| Netilmicin | Aminoglycosides | J01GB07 | Watch | No |\n| Norfloxacin | Fluoroquinolones | J01MA06 | Watch | No |\n| Ofloxacin | Fluoroquinolones | J01MA01 | Watch | No |\n| Oleandomycin | Macrolides | J01FA05 | Watch | No |\n| Oxytetracycline | Tetracyclines | J01AA06 | Watch | No |\n| Panipenem | Carbapenems | to be assigned | Watch | No |\n| Pazufloxacin | Fluoroquinolones | J01MA18 | Watch | No |\n| Pefloxacin | Fluoroquinolones | J01MA03 | Watch | No |\n| Pheneticillin | Penicillins | J01CE05 | Watch | No |\n| Piperacillin | Penicillins | J01CA12 | Watch | No |\n| Piperacillin\u002Ftazobactam | Beta lactam – beta lactamase inhibitor (anti-pseudomonal) | J01CR05 | Watch | Yes |\n| Pristinamycin | Streptogramins | J01FG01 | Watch | No |\n| Prulifloxacin | Fluoroquinolones | J01MA17 | Watch | No |\n| Ribostamycin | Aminoglycosides | J01GB10 | Watch | No |\n| Rifabutin | Rifamycins | J04AB04 | Watch | No |\n| Rifampicin | Rifamycins | J04AB02 | Watch | No |\n| Rifamycin | Rifamycins | J04AB03 | Watch | No |\n| Rifaximin | Rifamycins | A07AA11 | Watch | No |\n| Roxithromycin | Macrolides | J01FA06 | Watch | No |\n| Rufloxacin | Fluoroquinolones | J01MA10 | Watch | No |\n| Sisomicin | Aminoglycosides | J01GB08 | Watch | No |\n| Sitafloxacin | Fluoroquinolones | J01MA21 | Watch | No |\n| Sparfloxacin | Fluoroquinolones | J01MA09 | Watch | No |\n| Spiramycin | Macrolides | J01FA02 | Watch | No |\n| Spiramycin\u002Fmetronidazole | Combination of antibiotics | J01RA04 | Watch | No |\n| Streptomycin | Aminoglycosides | J01GA01 | Watch | No |\n| Sulbenicillin | Penicillins | J01CA16 | Watch | No |\n| Tebipenem | Carbapenems | J01DH06 | Watch | No |\n| Teicoplanin | Glycopeptides | J01XA02 | Watch | No |\n| Telithromycin | Macrolides | J01FA15 | Watch | No |\n| Temocillin | Carboxypenicillins | J01CA17 | Watch | No |\n| Ticarcillin | Carboxypenicillins | J01CA13 | Watch | No |\n| Tobramycin | Aminoglycosides | J01GB01 | Watch | No |\n| Tosufloxacin | Fluoroquinolones | J01MA22 | Watch | No |\n| Vancomycin (IV) | Glycopeptides | J01XA01 | Watch | Yes |\n| Vancomycin (oral) | Glycopeptides | A07AA09 | Watch | Yes |\n\n## Reserve group antibiotics\n\nReserve group includes antibiotics and antibiotic classes that should be reserved for the treatment of confirmed or suspected infections due to multi-drug-resistant organisms. Reserve group antibiotics should be treated as **“last resort”** options.\n\n| Antibiotic | Class | ATC code | Category | Listed on EML 2019 |\n| --- | --- | --- | --- | --- |\n| Aztreonam | Monobactams | J01DF01 | Reserve | No |\n| Ceftaroline fosamil | Fifth-generation cephalosporins | J01DI02 | Reserve | No |\n| Ceftazidime-avibactam | Third-generation cephalosporins | J01DD52 | Reserve | Yes |\n| Ceftobiprole medocaril | Fifth-generation cephalosporins | J01DI01 | Reserve | No |\n| Ceftolozane-tazobactam | Fifth-generation cephalosporins | J01DI54 | Reserve | No |\n| Colistin | Polymyxins | J01XB01 | Reserve | Yes |\n| Dalbavancin | Glycopeptides | J01XA04 | Reserve | No |\n| Dalfopristin-quinupristin | Streptogramins | J01FG02 | Reserve | No |\n| Daptomycin | Lipopeptides | J01XX09 | Reserve | No |\n| Eravacycline | Tetracyclines | J01AA13 | Reserve | No |\n| Faropenem | Penems | J01DI03 | Reserve | No |\n| Fosfomycin (IV) | Phosphonics | J01XX01 | Reserve | Yes |\n| Linezolid | Oxazolidinones | J01XX08 | Reserve | Yes |\n| Meropenem-vaborbactam | Carbapenems | J01DH52 | Reserve | Yes |\n| Minocycline (IV) | Tetracyclines | J01AA08 | Reserve | No |\n| Omadacycline | Tetracyclines | to be assigned | Reserve | No |\n| Oritavancin | Glycopeptides | J01XA05 | Reserve | No |\n| Plazomicin | Aminoglycosides | to be assigned | Reserve | Yes |\n| Polymyxin B | Polymyxins | J01XB02 | Reserve | Yes |\n| Tedizolid | Oxazolidinones | J01XX11 | Reserve | No |\n| Telavancin | Glycopeptides | J01XA03 | Reserve | No |\n| Tigecycline | Glycylcyclines | J01AA12 | Reserve | No |\n\n![](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FRESERVE-WHO.png)Selected Reserve group antibiotics are listed as individual medicines on the WHO Model Lists of Essential Medicines when they have a favorable risk-benefit profile and proven activity against [“Critical Priority” or “High Priority” pathogens identified by the WHO Priority Pathogens List](https:\u002F\u002Fwww.who.int\u002Fmedicines\u002Fareas\u002Frational_use\u002FPPLreport_2017_09_19.pdf?ua=1), notably carbapenem-resistant *Enterobacteriaceae*. These antibiotics should be accessible, but their use should be tailored to highly specific patients and settings when all alternatives have failed or are not suitable. These medicines could be protected and prioritized as key targets of national and international stewardship programs involving monitoring and utilization reporting, to preserve their effectiveness.\n\n**References and further readings**\n\n- [AWaRe WHO Antibiotic Categorization](https:\u002F\u002Faware.essentialmeds.org\u002Fgroups)\n\n*Note: This classification and content is reproduced from WHO website.*",[],[],[],[49,55,62,67,71,75,80,85,89,93],{"slug":50,"name":38,"description":51,"image":52,"body":53,"postCount":54},"acharya-tankeshwar","Editor-in-chief","https:\u002F\u002Fassets.microbeonline.com\u002Fauthors\u002Ftankeshwar-acharya-author-microbeonline.jpg","***Tankeshwar Acharya, MSc (Medical Microbiology)***\n\n*Tankeshwar Acharya is an Assistant Professor in the Department of Microbiology at Patan Academy of Health Sciences (PAHS), Nepal, where he has been teaching and practicing clinical microbiology for over 14 years. He is the founder of Microbe Online, one of the leading free microbiology education resources on the web, covering bacteriology, mycology, parasitology, immunology, and clinical laboratory diagnostics written from direct experience in both the classroom and the diagnostic laboratory.*",433,{"slug":56,"name":57,"description":58,"image":59,"body":60,"postCount":61},"ashma-shrestha","Ashma Shrestha","SEO Copywriter and Science Communicator\nKathmandu, Nepal","https:\u002F\u002Fassets.microbeonline.com\u002Fauthors\u002Fashma-shrestha.png","Ashma Shrestha holds a Master of Science in Medical Microbiology from the Institute of Science and Technology (IOST), Tribhuvan University, Nepal, where she developed a strong foundation in virology, molecular biology, and diagnostic microbiology.\n\nShe now works as an SEO Copywriter at Resolution Digital, where she combines her scientific training with research-driven content strategy. She is certified in Google Analytics and Google Business Profile (GBP), and brings a data-informed approach to science communication writing content that is not only accurate but structured to reach and serve the students who need it most.\n\nAt microbeonline, Ashma contributes articles primarily in virology and molecular biology, areas she finds most compelling for their mechanistic depth and their growing clinical relevance. Her writing reflects the same standard the site is built on: factual rigor, clear explanation of the *why* behind microbiology concepts, and content that helps students move from memorization to genuine understanding.\n\nShe is passionate about making complex microbiological concepts accessible without sacrificing accuracy; a skill that sits at the intersection of her scientific training and her professional work in content and SEO.",81,{"slug":63,"name":64,"description":65,"image":37,"body":37,"postCount":66},"sushmita-baniya","Sushmita Baniya","Author \u002F Contributor",32,{"slug":68,"name":69,"description":65,"image":37,"body":37,"postCount":70},"samikshya-acharya","Samikshya Acharya",20,{"slug":72,"name":73,"description":65,"image":37,"body":37,"postCount":74},"alisha-tripathi","Alisha Tripathi",6,{"slug":76,"name":77,"description":78,"image":37,"body":37,"postCount":79},"aastha-shrestha","Aastha Shrestha"," Author \u002F Contributor",10,{"slug":81,"name":82,"description":83,"image":37,"body":37,"postCount":84},"guest-author","Guest Author","Guest Author \u002F Contributor",2,{"slug":86,"name":87,"description":65,"image":37,"body":37,"postCount":88},"srijana-khanal","Srijana Khanal",18,{"slug":90,"name":91,"description":83,"image":37,"body":37,"postCount":92},"dr-poonam-acharya","Dr. Poonam Acharya",1,{"slug":94,"name":95,"description":65,"image":37,"body":96,"postCount":97},"nisha-rijal","Nisha Rijal","**Nisha Rijal** is a microbiologist and quality assurance specialist. She served for nearly 12 years as a microbiologist at the National Public Health Laboratory (NPHL), Nepal's national reference laboratory, and continues to work as a consultant microbiologist in international public health organization. ",51]