The World Health Organization (WHO) has updated its Model List of Essential Medicines for 2017, grouping antibiotics into 3 categories—access, watch, and reserve—advising when each category should be used to treat the most common general infections. The guide also adds 30 medicines for adults and 25 for children while specifying new uses for 9 already listed products.
“Safe and effective medicines are an essential part of any health system,” said Marie-Paule Kieny, PhD, WHO assistant director-general for health systems and innovation. “Making sure all people can access the medicines they need, when and where they need them, is vital to countries’ progress toward universal health coverage.”
The new categorizations aim to ensure that treatments are available when needed and that the right antibiotics are prescribed for the right infections. They also will enhance outcomes, reduce the development of drug-resistant bacteria, and preserve the effectiveness of “last resort” antibiotics that are needed when all others fail, according to WHO.
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, which is widely used to treat infections such as pneumonia. Amikacin, ampicillin, cephalexin, cloxacillin, and others also are on the access list.
The watch antibiotics are recommended as first or second choice treatments for a small number of infections. For instance, WHO reports that the use of ciprofloxacin, used to treat cystitis and upper respiratory tract infections, should be dramatically reduced to prevent further antimicrobial 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, according to WHO.
“The rise in antibiotic resistance stems from how we are using and misusing these medicines,” said Suzanne Hill, PhD, director of essential medicines and health products. “The new WHO list should help health system planners and prescribers ensure people who need antibiotics have access to them and ensure they get the right one so that the problem of resistance doesn’t get worse.”
Additionally, WHO has added 10 antibiotics to the list for adults and 12 for children. Other new drugs include 2 oral cancer treatments, a new pill for hepatitis C, a more effective treatment for HIV, an older drug that can be taken to prevent HIV infection in people at high risk, new pediatric formulations of medicines for tuberculosis, and pain relievers.
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