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Clin Infect Dis. 2016 Oct 15;63(8):1087-1093. doi: 10.1093/cid/ciw475. Epub 2016 Jul 20.

World Health Organization Ranking of Antimicrobials According to Their Importance in Human Medicine: A Critical Step for Developing Risk Management Strategies to Control Antimicrobial Resistance From Food Animal Production.

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Infectious Diseases and Microbiology, Canberra Hospital.
Medical School, Australian National University, Acton, Australia.
Departments of Medicine, Microbiology, Immunology & Infectious Diseases, and Pathology & Laboratory Medicine, Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada.
University of Paris-Diderot Medical School, Paris, France.
Department of Population Medicine, University of Guelph, Ontario, Canada.
Department of Food Safety and Zoonosis, World Health Organization, Geneva, Switzerland.


Antimicrobial use in food animals selects for antimicrobial resistance in bacteria, which can spread to people. Reducing use of antimicrobials-particularly those deemed to be critically important for human medicine-in food production animals continues to be an important step for preserving the benefits of these antimicrobials for people. The World Health Organization ranking of antimicrobials according to their relative importance in human medicine was recently updated. Antimicrobials considered the highest priority among the critically important antimicrobials were quinolones, third- and fourth-generation cephalosporins, macrolides and ketolides, and glycopeptides. The updated ranking allows stakeholders in the agriculture sector and regulatory agencies to focus risk management efforts on drugs used in food animals that are the most important to human medicine. In particular, the current large-scale use of fluoroquinolones, macrolides, and third-generation cephalosporins and any potential use of glycopeptides and carbapenems need to be addressed urgently.


animals; antimicrobial resistance; antimicrobials; food production; risk management

[Indexed for MEDLINE]

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