WHAT DOES “ANTIBIOTIC RANK” MEANS?

The use of antibiotics is critical to maintaining both human and animal health, ensuring food safety, and preventing the spread of zoonotic diseases. However, concerns about antibiotic resistance have prompted the need to rank veterinary antibiotics based on their importance, usage, and associated risks. This ranking or categorization serves as a tool to support veterinarians in making informed decisions about which antibiotics to use.

The AMEG and AVA proposes to classify antibiotics in four different categories, which are:

Category A (“Avoid”)/ Restricted: Antibiotic that is not authorized in veterinary medicine but authorized in human medicine in the EU. These drugs are vitally important to human health so should never be used in animals.
Category B (“Restrict”)/ Tertiary/ 3rd line: Antibiotics that are of great importance to animal and human health especially for the treatment of multidrug resistant bacteria, and where resistance is

more likely occur following use and/or is of great concern in veterinary and human healthcare.

Category C (“Caution”)/ Secondary/ 2nd line: Antibiotics that are often broad-spectrum that are important for animal and human health and in which resistance is more likely to occur. For substances proposed for inclusion in this category, there are in general alternatives in human medicine in the EU but there are few alternative antibiotics in veterinary medicine for certain indications.
Category D (“Prudence”)/ Primary/ 1st line: Antibiotics that are well established with good evidence of high efficacy and safety. Ideally, they should be narrow-spectrum.