Table 3.
List, classification and prioritization of antimicrobials categorized as critically important in human and veterinary medicine.
| Antibiotic | Disc concentration | Antimicrobial class | Medical importance (53) | Prioritization criterion |
|---|---|---|---|---|
| Colistin | 600 µg | Polymyxins | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Cephradine | 10 µg | Cephalosporins | Highly Important Antimicrobials | NA |
| Ceftiofur | 10 µg | Cephalosporins | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Fosfomycin | 5 µg | Phosphonic acid derivatives | High Priority Critically Important Antimicrobials | P1 and P2 |
| Gentamycin | 20 µg | Aminoglycosides | High Priority Critically Important Antimicrobials | P2 and P3 |
| Neomycin | 30 µg | Aminoglycosides | High Priority Critically Important Antimicrobials | P2 and P3 |
| Streptomycin | 5 µg | Aminoglycosides | High Priority Critically Important Antimicrobials | P2 and P3 |
| Chloramphenicol | 15 µg | Amphenicols | Highly Important Antimicrobials | NA |
| Enrofloxacin | 10 µg | Quinolones and fluoroquinolones | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Ciprofloxacin | 10 µg | Quinolones and fluoroquinolones | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Norfloxacin | 10 µg | Quinolones and fluoroquinolones | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Flumequine | 5 µg | Quinolones and fluoroquinolones | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Pefloxacin | 5 µg | Quinolones and fluoroquinolones | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Amoxicillin | 10 µg | Penicillins | Highest Priority Critically Important Antimicrobials | P2 and P3 |
| Ampicillin | 10 µg | Penicillins | Highest Priority Critically Important Antimicrobials | P2 and P3 |
| Sulfamethoxazole/Trimethoprim | 15 µg | Sulfonamides, dihydrofolate reductase inhibitors combination | Highly Important Antimicrobials | NA |
| Spiramycin | 5 µg | Macrolides and ketolides | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Erythromycin | 20 µg | Macrolides and ketolides | Highest Priority Critically Important Antimicrobials | P1, P2 and P3 |
| Spectinomycin | 5 µg | Aminocyclitols | Important Antimicrobials | NA |
| Rifampicin | 5 µg | Ansamycins | Highest Priority Critically Important Antimicrobials | P1 and P2 |
| Oxytetracyclin | 20 µg | Tetracyclines | Highly Important Antimicrobials | NA |
| Doxycycline | 20 µg | Tetracyclines | Highly Important Antimicrobials | NA |
| Clindamycin | 20 µg | Lincosamides | Highly Important Antimicrobials | NA |
Prioritization criterion 1 (P1): High absolute number of people, or high proportion of use in patients with serious infections in health care settings affected by bacterial diseases for which the antimicrobial class is the sole or one of few alternatives for treating serious infections in humans. Prioritization criterion 2 (P2): High frequency of use of the antimicrobial class for any indication in human medicine, or high proportion of use in patients with serious infections in health care settings, because use may favor selection of resistance in both settings. Prioritization criterion 3 (P3): The antimicrobial class is used to treat infections in people for whom there is evidence of transmission of resistant bacteria (e.g., non-typhoidal Salmonella and Campylobacter spp.) or resistance genes (high for E. coli and Enterococcus spp.) from non-human sources. NA: not available.