WHO releases new essential drug list to curb antimicrobial resistance

The World Health Organization (WHO) has released a new “essential medicines list” categorizing antibiotics into three groups in an attempt to fight antimicrobial resistance.

The new classification list includes 39 antibiotics for 21 common syndromes classified into “Access”, “Watch” and “Reserve” groups, with penicillin-type drugs recommended as the first line of defense and others only for use when absolutely necessary.

Drugs on the “Access” list have lower resistance potential and include the widely-used amoxicillin.

The “Watch” list includes ciprofloxacin, which is commonly prescribed for cystitis and strep throat but “not that effective”, WHO Assistant Director-General for Health Systems and Innovation Marie-Paule Kieny told reporters.Its use should be “dramatically reduced”, the WHO said.

“We think that the political will is there but this needs to be followed by strong policies,”Kieny said.

In the “Reserve” category, antibiotics such as colistin should be seen as a last resort. That prompts questions about how producers of such antibiotics could make money, said Suzanne Hill, WHO’s Director of Essential Medicines and Health Products.

“What we need to do is stop paying for antibiotics based on how many times they are prescribed, to discourage use. We don’t want colistin used very frequently. In fact we don’t want it used at all,” Hill said.

“What we need to do as a global community is work out how we pay the company not to market colistin and not to promote it and to keep it in reserve.”

The WHO classification takes into account the use of antibiotics for animal health use, and was developed together with the UN Food and Agriculture Organization and the World Organization for Animal Health.

Other changes to the list included the addition of two oral cancer treatments, a new pill for hepatitis C that combines two medicines, a more effective treatment for HIV, and new pediatric formulations of medicines for tuberculosis.

But the WHO also said Roche’s well-known flu drug oseltamivir, marketed as Tamiflu, may be removed from the list unless new information supports its use in seasonal and pandemic influenza outbreaks.

“There is an updated data set compared to when the committee evaluated this product last, and what that suggests is that the size of the effect of oseltamivir in the context of pandemic influenza is less than previously thought,” Hill said.

However, Hill added that oseltamivir was the only antiviral listed, and it was still useful for pregnant women and patients with complications so it use should be restricted to the most critical patients.

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Category: Features, Pharmaceuticals