How important is the list of Category I Antimicrobials and why is Health Canada recommending against their use in an ELDU manner?
The antimicrobials in Category I are considered of “very high importance” or “critically important” in human medicine as they are essential for the treatment of serious bacterial infections and there are limited or no availability of alternative antimicrobials in case of resistance to these antimicrobials. Health Canada is recommending against their use in an ELDU manner because it is essential that we protect the efficacy of these drugs by using them prudently and judiciously, as indicated on the approved label. The current list of Category I antimicrobials includes the following examples: • Carbapenems • Cephalosporins – the third and fourth generations • Fluoroquinolones • Glycopeptides • Glycylcyclines • Ketolides • Lipopeptides • Monobactams • Nitroimidazoles (metronidazole) • Oxazolidinones • Penicillin – β-lactamase inhibitor combinations • Polymyxins (colistin) • Streptogramins • Therapeutic agents for tuberculosis (e.g.
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