The WHO has released a list of 21 antimicrobials earmarked as “authorised for use in humans only” – a first for the organisation in its efforts to protect overuse and abuse of critical first-line drugs that need to be protected by over-use in animal and plant health sectors, and consequent antimicrobial resistance (AMR).
Significantly, most of the 21 antimicrobials earmarked include mostly novel compounds developed and authorised over the past six years, reports Health Policy Watch.
The category “mainly contains newer antimicrobials that are very important in treating serious multidrug-resistant infections in humans”, the agency said.
So the new label is effectively a warning sign to the farm industry that they should not be used in animals or plants in the future.
Among the antimicrobials listed are: plazomicin, aminomethylcycline, anti-pseudomonal penicillins with and without β-lactamase inhibitors, carbapenems with or without inhibitors, third- and fourth-generation cephalosporins with β-lactamase inhibitors, sulfones, as well as drugs critical to treating tuberculosis and other mycobacterial diseases.
Some of the older ones on the WHO list, e.g, carbapenems, are not licensed for use in animals in the United States, but are sometimes used in companion animals.
The report aims to provide guidance for authorities in the public health and animal health sectors, veterinarians, prescribers of antimicrobials, and agricultural professionals, as well as classify antimicrobial categories by importance to human use, WHO said.
A second category of medically important antimicrobials refers to drugs “authorised for use in both humans and animals”, but categorised into “highest priority critically important antimicrobials (HPCIA)”, “critically important antimicrobials (CIA)”, “highly important antimicrobials” and “important antimicrobials.”
To address risks, the use of critical antimicrobials must be rationalised more systematically in both animal as well as human health, and WHO’s drug classifications create an order of priority for doing this, notes an analysis from the University of Minnesota-based Centre for Infectious Disease Research and Policy (CIDRAP.)
“The risk to human health is greatest if the antimicrobials listed as ‘authorised for use in humans only’ are used in non-human sectors,” said the CIDRAP analysis. “Those risks and impacts decline progressively with the use of agents from the other categories.”
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