News-CRUX-10     12th January 2024        

Context: The findings of a new survey by the National Centre for Disease Control (NCDC) underscored the need for directing more efforts for appropriate stewardship in antibiotic use practices, particularly Critically Important Antimicrobials (CIAs) and in mitigation of antimicrobial resistance.

Critically Important Antimicrobials (CIA)

  • Background: There is growing agreement in animal agriculture that antimicrobials that are Critically Important to human medicine – or CIAs - should be treated as a special category when finding ways to tackle the threat of antimicrobial resistance. There are three classes of antimicrobial agents that all the groups place at highest priority: fluoroquinolones, 3rd and 4th generation cephalosporins and macrolides.
  • Classification by WHO

oCIAs represent a class of antimicrobials. WHO categorizes them based on their importance in human medicine and the urgency to preserve their effectiveness against infectious diseases.

  • Subcategory: HPCIAs are a subset within CIAs, signifying the highest-priority antimicrobials in terms of preserving effectiveness. They include 3rd generation cephalosporins, among others.
  • Limitation and Scope: The classification is limited to antibacterial drugs, primarily used in human and veterinary medicine.

oIt focuses on antibiotics used in food animals and crops.

  • Antibiotic Prescriptions: 3rd generation cephalosporins, especially Ceftriaxone, are most frequently prescribed.

oAminoglycosides, with amikacin as the top choice, rank second in overall antibiotic prescriptions.

  • CIAs include: Carbapenems, penicillins, fluoroquinolones, glycopeptides, and macrolides.
  • Significance of Listing: Listing aids in managing antimicrobial resistance.

oIt ensures prudent use of all antimicrobials, especially CIAs, in both human and veterinary medicine.