WHO updates guidance on antibiotic use for common infections

The World Health Organization updated its list of essential medicines Tuesday, including the biggest revision of the antibiotic section since the Essential Medications List was first written 40 years ago.

WHO now groups antibiotics into three categories — Access, Watch and Reserve — and offers recommendations as to when each category should be used. The categories include antibiotics used to treat 21 common general infections.

"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."

Below is information on the three new categories of antibiotics.

Access. This group include amoxicillin, ciprofloxacin and other drugs widely used to treat common infections. WHO recommends antibiotics in this group be available at all times.

Watch. This category includes antibiotics that have a higher resistance potential, and WHO recommends using them as first- or second-choice treatments for a few specific infections. "These medications should be prioritized as key targets of stewardship programs and monitoring," according to the updated EML. Drugs here include carbapenems, quinolones and fluoroquinolones, among others.

Reserve. Antibiotics in this group should be considered a "last resort" and only used in specific patients and settings when other drugs have failed. Examples include fourth and fifth generation cephalosporins, tigecycline and polymyxins.

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