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World Health Organisation issues new advice on antibiotics prescribing

The World Health Organisation (WHO) has updated its Essential Medicines List with advice on which antibiotics to prescribe in which circumstances.

As part of work to halt increasing rates of antimicrobial resistance, WHO has grouped antibiotics into three groups – those that can be widely used (‘Access’), those that should be used with caution (‘Watch’) and those only to use in life-threatening circumstances (‘Reserve’).

Drugs on the ‘Reserve’ list 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’.

On the ‘Watch’ list are ‘antibiotics that are recommended as first- or second-choice treatments for a small number of infections’. This includes for example ciprofloxacin, which is used to treat cystitis and upper respiratory tract infections but WHO says these ‘should be dramatically reduced to avoid further development of resistance’.

Meanwhile, drugs on the ‘Access’ list should be ‘available at all times as treatments for a wide range of common infections’ such as pneumonia, including for example amoxicillin.

RCGP chair Dr Helen Stokes-Lampard welcomed the WHO ‘taking action’ to help curb the ‘serious threat’ of growing resistance to antibiotics.

She added: ‘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.

‘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.’

She added that ‘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’.


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