New advice on antibiotics use has been released by the World Health Organisation, WHO. in its new Essential Medicines List (EML)
The new updated guidelines differentiate which antibiotics to use for common infections and which to preserve for the most serious circumstances.This is contained among additions to the WHO Model list of essential medicines for 2017. Other additions include medicines for HIV, hepatitis C, tuberculosis and leukaemia.
The updated list adds 30 medicines for adults and 25 for children, and specifies new uses for nine already-listed products, bringing the total to 433 drugs deemed essential for addressing the most important public health needs.
The EML is used by many countries to increase access to medicines and guide decisions about which products they ensure are available for their populations.
WHO experts have grouped antibiotics into three categories – access, watch and reserve – with recommendations on when each category should be used. Initially, the new categories apply only to antibiotics used to treat 21 of the most common general infections. If shown to be useful, it could be broadened in future versions of the EML to apply to drugs to treat other infections.
The change aims to ensure that antibiotics are available when needed, and that the right antibiotics are prescribed for the right infections. It should enhance treatment outcomes, reduce the development of drug-resistant bacteria, and preserve the effectiveness of “last resort” antibiotics that are needed when all others fail.
WHO recommends that antibiotics in the access group be available at all times as treatments for a wide range of common infections. For example, it includes amoxicillin, a widely-used antibiotic to treat infections such as pneumonia.
The watch group includes antibiotics that are recommended as first- or second-choice treatments for a small number of infections, eg., the use of ciprofloxacin, used to treat cystitis (a type of urinary tract infection) and upper respiratory tract infections (such as bacterial sinusitis and bacterial bronchitis), should be dramatically reduced to avoid further development of resistance.
The reserve group, includes antibiotics such as colistin and some cephalosporins that should be considered last-resort options, and used only in the most severe circumstances when all other alternatives have failed, such as for life-threatening infections due to multidrug-resistant bacteria.