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Critically Important Antibiotics (CIAs)

The use of antibiotics in both human and veterinary medicine leads to the development and spread of AMR.  To preserve the efficacy of antibiotics, improved management in the use of antibiotics in animals particularly those also used in human medicine is required. 

The World Health Organisation (WHO) categories antibiotics used in human health as “critically important”, “highly important” and “important” to human health.  Highly Important and Important antibiotics must be used with care and use of these antibiotics are addressed by the prudent use guidelines developed by the Veterinary Council of Ireland. 

Critically Important Antibiotics or CIAs are the most important antibiotics to human health.  Critically Important Antibiotics (CIAs) are further categorised into Highest Priority CIAs (Category 1) and High Priority CIAs (Category 2). 

CIAs are classes of antibiotics that are a last resort and are crucial in treating human disease where first line antibiotics have not worked.  Highest Priority CIAs (Category 1) should NOT be used to prevent disease or as a first line of treatment in animals (prophylactic use).  These HP-CIAs should only be used when there are no effective alternative antibiotics available for the treatment of bacterial disease.  High Priority CIAs (Category 2) includes antibiotics that pose a risk to human health from veterinary use.  Therefore, it is only acceptable to use High Priority CIAs (Category 2) provided that specific restrictions are placed on their use.  The final category, referred to as Category 3 are antibiotics that are not approved for use in animals and therefore should not be prescribed for or administered to animals. 

We need to ensure that these antibiotics remain effective for people and animals into the future. It is vital that these last resort antibiotics are effective in human medicine and therefore must never be used as first line treatment in animals.

A policy document has been published by the Department of Agriculture Food and the Marine which outlines the conditions that these last resort antibiotics should be used in veterinary medicine - Policy on Highest Priority Critically Important Antimicrobials (PDF).

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