WHO make revisions to antibiotics advice

Credit: This story was first seen on On Medica

The World Health Organisation has implemented its biggest ever revision to its advice on antibiotics as part of its updated Essential Medicines List, On Medica reports.

The 2017 Essential Medicines List (EML) 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.

In the biggest revision of the antibiotics section in the EML’s 40-year history, 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. These changes support WHO’s global action plan on antimicrobial resistance, which aims to fight the development of drug resistance by ensuring the best use of antibiotics.

WHO recommends that antibiotics in the ACCESS group (which includes amoxicillin) be available at all times as treatments for a wide range of common infections.

The WATCH group includes antibiotics that are recommended as first or second choice treatments for a small number of infections. For example, the use of ciprofloxacin, used to treat cystitis and upper respiratory tract infections, should be dramatically reduced to avoid further development of resistance.

The third group, RESERVE, 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.

WHO experts have added 10 antibiotics to the list for adults, and 12 for children.

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The updated EML also includes several new drugs, such as two oral cancer treatments, a new pill for hepatitis C that combines two medicines, a more effective treatment for HIV as well as an older drug that can be taken to prevent HIV infection in people at high risk, new paediatric formulations of medicines for tuberculosis, and pain relievers.

“Safe and effective medicines are an essential part of any health system,” said Dr Marie-Paule Kieny, 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 towards universal health coverage.”

The RCGP has welcomed the update. Its chair, Professor Helen Stokes-Lampard, said: “Growing resistance to antibiotics is a serious threat to our patients’ health worldwide, so we welcome the World Health Organisation taking action to help curb this. GPs and other prescribers must have access to guidance and tools that help us prescribe safely for all conditions, in the best interests of individual patients and public health globally – and this updated Essential Medicines List should be useful in our daily practice.”

She added: “It’s important that the list is constantly evaluated and updated as new research is published, in a way that best preserves the efficacy of the drugs we have available to us for as long as possible, in the long-term interests of the health of our global population. What is also necessary is for more investment and research into developing new drugs, particularly antibiotics, so that we have more options available to tackle emerging diseases, so that we can keep our patients safe for years to come.