Terming it the most dramatic alteration of the Essential Medicines List (EML) in the four decade history of the document, the World Health Organization (WHO) has grouped antibiotics in three separate categories. The stated goal is the reduced use of the antimicrobial drugs in hopes that it will quell the rising problem of devastating superbugs.

The drug-resistant “nightmare bacteria” have added an entirely new level of patient safety threat in hospitals and other healthcare facilities worldwide. The CDC says at least 2 million people per year are infected with superbugs in the U.S, and the infection is fatal for at 23,000 of those patients annually.


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The revised EML sorts antibiotics into three categories: ACCESS, WATCH, and RESERVE.

The WHO recommends that ACCESS antibiotics “should be widely available, affordable, and quality-assured.” This group includes amoxicillin, cefalexin, and doxycycline.

The WATCH group is comprised of antibiotics with “higher resistance potential,” and the WHO recommends they are employed with caution. Ciprofloxacin and azithromycin are among the medications in this category.

Finally, the WHO has designated some antibiotics as appropriate only as a “last resort.” This is the RESERVE group, and it includes cefepime, ceftaroline, polymyxin B, and colistin. “These medicines could be protected and prioritized as key targets of national and international stewardship programs involving monitoring and utilization reporting, to preserve their effectiveness,” the EML states.

In a press release accompany the revised EML, Dr. Suzanne Hill, director of essential medicines at the WHO, argues the new approach is a necessary corrective to the prescription patterns of the past.

"The rise in antibiotic resistance stems from how we are using — and misusing — these medicines," Hill said. "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."