Food safety

WHO list of critically important antimicrobials (WHO CIA list)

WHO CIA list 6th revision newly released in 2019

Members of the WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR) met at the eighth meeting of the AGISAR in Utrecht, the Netherlands in 2018, and updated the WHO list of critically important antimicrobials for human medicine for its 6th time.

Use of antimicrobials in food animals can create an important source of antimicrobial resistant bacteria that can spread to humans through the food supply. Improved management of the use of antimicrobials in food animals, particularly reducing those critically important for human medicine, is an important step towards preserving the benefits of antimicrobials for people. WHO has developed and applied criteria to rank antimicrobials according to their relative importance in human medicine. Clinicians, regulatory agencies, policy-makers and other stakeholders can use this ranking when developing risk management strategies for the use of antimicrobials in food production animals. The use of the list will help preserve the effectiveness of currently available antimicrobials.

The first WHO list of CIA was developed in the 1st WHO Expert Meeting on Critically Important Antimicrobials for Human Health held in Canberra, Australia, 2005. During the meeting, participants considered the list of all antimicrobial classes used in human medicine and categorized antimicrobials into three groups of critically important, highly important, and important based on the two criteria developed during the meeting.

The 1st revision of the WHO list of CIA was developed in the 2nd WHO Expert Meeting on Critically Important Antimicrobials for Human Health held in Copenhagen, Denmark, 2007. In this meeting, participants reviewed the two criteria and re-examined the categorization of all human antibacterial classes to prepare the 2nd edition of the list. Participants also prioritized agents within the critically important category in order to allow allocation of resources on the agents for which management of the risks from antimicrobial resistance are needed most urgently.

The list has subsequently been re-examined and updated during WHO-AGISAR expert meetings held in Copenhagen in 2009 (2nd revision), in Oslo, Norway in 2011 (3rd revision), in Bogota, Colombia in 2013 (4th revision), in Raleigh, USA (5th revision), and in Utrecht, the Netherlands in 2018 (6th revision).