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'Critically Important Antimicrobials for Human Medicines' (WHO CIA List)

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'Critically Important Antimicrobials for Human Medicines' (WHO CIA List) WHO list of Critically Important Antimicrobials for Human Medicine (WHO CIA list) Prioritize Since 2005, WHO has produced a regularly updated list by Prioritization Criterion 1, 2, 3 of all antimicrobials currently used for human medicine Critically Important (mostly also used in veterinary medicine), grouped into 3 categories based on their importance to human Highly Important Highest Priority medicine. The list is intended to assist in managing antimicrobial resistance, ensuring that all antimicrobials, Important High Priority especially critically important antimicrobials, are used prudently both in human and veterinary medicine. Classify by Criterion 1, 2 Infections from drug resistant bacteria can be more severe and imicrobia Antimicrobials are given to nt ls difficult to treat than those from food producing animals A * drug susceptible bacteria Antimicrobial Resistance (AMR) along the food chain Drug resistant …and can be bacteria develop transferred to in animals people by eating food Drug resistant bacteria can …and to food spread to the environment WHO supports optimization of the use of antimicrobial medicines in human and animal to preserve their effectiveness by taking a One Health approach *The scope of this list is limited to the antibacterial drugs (antibiotics). WHO Critically Important Antimicrobials for Human Medicine 5 th revision Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR) October 2016 Summary of classification and prioritization of antimicrobials categorized as Critically Important, Highly Important and Important Antimicrobial class Criterion (Yes= ● ) CRITICALLY IMPORTANT ANTIMICROBIALS C1 C2 P1 P2 P3 HIGHEST PRIORITY C1 Criterion 1 Cephalosporins (3 rd, 4th and 5th generation) Glycopeptides The antimicrobial class is the Macrolides and ketolides sole, or one of limited available therapies, to treat serious Polymyxins bacterial infections in people. Highest Priority Highest Quinolones C2 Criterion 2 HIGH PRIORITY Aminoglycosides The antimicrobial class is used Ansamycins to treat infections in people caused by either: (1) bacteria Carbapenems and other penems that may be transmitted to Glycylcyclines humans from nonhuman Critically Important Lipopeptides sources, or (2) bacteria that Monobactams may acquire resistance genes from nonhuman sources. Oxazolidinones Penicillins (natural, aminopenicillins, and antipseudomonal) P1 Prioritization criterion 1 Phosphonic acid derivatives High absolute number of people, Drugs used solely to treat tuberculosis or other mycobacterial diseases or high proportion of use in patients with serious infections HIGHLY IMPORTANT ANTIMICROBIALS C1 C2 P1 P2 P3 in health care settings affected Amidinopenicillins by bacterial diseases for which the antimicrobial class is the Amphenicols sole or one of few alternatives Cephalosporins (1st and 2nd generation) and cephamycins to treat serious infections in Lincosamides humans. Penicillins (anti-staphylococcal) P2 Prioritization criterion 2 Pseudomonic acids Medically Important Antimicrobials NA High frequency of use of the Riminofenazines antimicrobial class for any Steroid antibacterials indication in human medicine, Highly Important Streptogramins or else high proportion of use in patients with serious infections Sulfonamides, dihydrofolate reductase inhibitors and combinations in health care settings, since Sulfones use may favour selection of Tetracyclines resistance in both settings. P3 Prioritization criterion 3 IMPORTANT ANTIMICROBIALS C1 C2 P1 P2 P3 Aminocyclitols The antimicrobial class is used Cyclic polypeptides to treat infections in people for which there is evidence Nitrofurantoins NA of transmission of resistant Important Nitroimidazoles bacteria or resistance genes Pleuromutilins from non-human sources. WHO CIA list 5th rev. : http://who.int/foodsafety/publications/antimicrobials-fifth/en/ AGISAR: http://who.int/foodsafety/areas_work/antimicrobial-resistance/agisar/en © World Health Organization 2017. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence WHO/NMH/FOS/FZD/17.1.
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