RCGP backs WHO antibiotic priority list to fight resistance

The RCGP has backed a World Health Organisation (WHO) system to restrict the use of key antibiotics and protect them against rising resistance.

The WHO has updated its essential medicines list in a bid to crack down on unnecessary antibiotic use and help preserve vital treatments against the rising threat of antibiotic resistance.

In what it described as the biggest revision of its antibiotics section in the history of the list, the WHO has created a new three-point scale to categorise antibiotics. Treatements are allocated to 'access', 'watch' or 'reserve' groups depending on the circumstances in which they should be used.

The RCGP said the list could support GPs to prescribe safely in daily practice.

The new system only applies to antibiotics used to treat 21 of the most common general infections, but ‘could be broadened in future versions’ of the list if considered useful, the WHO said.

Antibiotics in the 'access' group – which includes amoxicillin, ampicillin and cloxacillin – are recommended to be available at all times for a wide range of infections.

Antibiotic prescribing

The 'watch' group of antibiotics are recommended as first- or second-choice treatments for a small number of infections. Use of these antibiotics should be ‘dramatically reduced’ to avoid further development of resistance.

The final group, 'reserve', should be considered ‘last-resort options’ to be used only in the most severe circumstances when all other options have failed, such as for life-threatening infections due to multidrug-resistant bacteria.

Eight antibiotics make this list, including aztreonam, fosfomycin and tigecycline. WHO recommended these treatments should be protected to preserve their effectiveness.

RCGP chair Professor Helen Stokes-Lampard said: ‘Growing resistance to antibiotics is a serious threat to our patients’ health worldwide, so we welcome the WHO 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.

Global health

‘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.’

Dr Suzanne Hill, director of essential medicines at the WHO, 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 list also adds 30 other medicines for adults and 25 for children, alongside specifying new uses for nine already-listed products. This brings the total list up to 433 drugs deemed essential for addressing the most important public health needs.

Photo: iStock

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