WHO’s Essential Medicine List updated, with new guidelines on how antibiotics should used

The World Health Organisation (WHO) has updated their Essential Medicines List (EML), adding 10 new antibiotics which should be used in adults, and 12 for children.

In addition, they’ve also decided to try a new approach to combat antibiotic resistant bacteria by dividing antibiotics into three different categories; access, watch and reserve. It’s hoped that these groups will help healthcare professionals make better decisions as to which drugs to use to treat infections. With improved guidelines the development of resistant strains could be reduced, and last-resort antibiotics, used to treat infections for which all other drugs have failed, are likely to maintain their efficiency for longer.

Antibiotics in the access category are those which should be widely available at low cost, and which should be used to treat the most common infections. Examples include amoxicillin and ampicillin.

The watch category is reserved for antibiotics which should be the first or second treatment choice for a small number of infections, but which are still considered to have higher potential to cause resistance. Seven classes were included in this group, such as the carbapenems and the quinolones.

The antibiotics which were grouped into reserve include those which should only be used as a final option, when no other antibiotics are working; in other words, last-resort antibiotics. Drugs in this category include aztreonam, daptomycin and the polymixins.

Initially, these categories have only been applied to 21 drugs used to treat the most common infections. If the new guidelines are effective, then the groups could be applied to more drugs in subsequent updates of the EML.

Dr Suzanne Hill, Director of Essential Medicines and Health Products, said “The rise in antibiotic resistance stems from how we are using – and misusing – these medicines. 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.”

The updated list also includes a number of other drugs, such as the oral cancer medicines dasatinib and nilotinib, and the HIV medicine dolutegravir.

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