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Abtibiotic section got a makeover in recent WHO essential medicine list

Author: Dr. Apurva Agrawal

WHO has recently issued 20th Model List of Essential Medicines. 30 medicines for adults and 25 for children have been added to the last essential medicine list. Special emphasis has been given to the use of antibiotics and an advice has been issued on which antibiotics to use for common infections and which to preserve for the most serious circumstances. Antibiotics are grouped into three categories: ACCESS, WATCH and RESERVE.

ACCESS GROUP: Antibiotics in this group should be available at all times as treatments for a wide range of common infections. It includes drugs like amoxicillin, amoxicillin + clavulanic acid, ampicillin, benzyl penicillin, cefalexin, cefazolin, amikacin, gentamicin, doxycycline, metronidazole and some others.

WATCH GROUP: This group includes antibiotics that have higher resistance potential, thus are recommended as first or second choice treatments for a small number of infections and their use should be reduced to avoid further development of resistance. It includes Quinolones, fluoroquinolones, 3rd gen cephalosporins, macrolides, glycopeptides, piperacillin + tazobactum, carbapenems.

RESERVE GROUP: Antibiotics in this group that should be considered as "last resort" options, their use should be restricted to highly specific patients, when all alternatives have failed (e.g., serious, life-threatening infections due to multi-drug resistant bacteria). It includes 4th & 5th gen cephalosporins, aztreonam, fosfomycin, polymixins, linezolid, tigecyclin, daptomycin.

This new categorization of antibiotics in EML is a step towards WHO's Global action plan on antimicrobial resistance, which aims to fight the development of drug resistance by ensuring the best use of antibiotics.

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