HP-CIAs – ‘last resort’ antibiotics

New scientific advice issued on 28 January 2020 by the European Medicines Agency (EMA) on risk categorisation of antibiotics for use in animals, including those which should be restricted for use as a last resort, has been recognised by RUMA as the most appropriate categorisation for the UK farm livestock sectors – albeit with more specific advice due shortly from the UK livestock species veterinary associations.

The EMA’s Antimicrobial Advice Ad-Hoc Expert Group (AMEG) constantly reassesses the impact on human health of using different antibiotics in animals, alongside the need to treat disease in animals for health and welfare reasons within the geographical region of Europe.

The main change in the new advice is that four ‘risk’ categories of antibiotics A to D have been identified, replacing the previous three categories.

Category A ‘Avoid’ replaces category 3; these are antibiotics which are reserved for human treatment only and are not permitted for use in food-producing animals.

Category B ‘Restrict’ replaces category 2; these are commonly known as the highest-priority Critically Important Antibiotics (HP-CIAs), and should be confined to use in veterinary medicine only as a last resort after sensitivity testing has been conducted, and when no other antibiotic would be clinically effective. The antibiotics in this group remain the same – namely 3rd and 4th generation cephalosporins, quinolones including fluoroquinolones and polymyxins, including colistin.

Category C ‘Caution’ is new, and signifies an elevated risk. Antibiotics in this category should only be used if there is no alternative lower-risk product available in Category D.

Category D ‘Prudence’ replaces category 1 as the lowest-risk group, but nonetheless advises all products should be used with prudence.

For more guidance on which products are HP-CIAs / Category B and should be used only as last resort on-farm, please refer to the table below or download the interactive HP CIA product list for food-producing animals updated 10 February 2020.

Product Name Route of administration Active Ingredient Ingredient Class Cattle Sheep Pigs Chickens Turkeys
Actionis Injection Ceftiofur Third Gen Ceph
Advocin Injection Danofloxacin Fluoroquinolone
Baytril Injection Enrofloxacin Fluoroquinolone
Baytril Oral Solution Enrofloxacin Fluoroquinolone
Boflox Injection Marbofloxacin Fluoroquinolone
Cefavex Injection Ceftiofur Third Gen Ceph
Cefenil Injection Ceftiofur Third Gen Ceph
Ceffect Injection Cefquinome Fourth gen ceph
Ceffect Intramammary Cefquinome Fourth gen ceph
Cefimam Intramammary Cefquinome Fourth gen ceph
Cefokel Injection Ceftiofur Third Gen Ceph
Ceftiocyl Injection Ceftiofur Third Gen Ceph
Ceftiosan Injection Ceftiofur Third Gen Ceph
Cemay Injection Ceftiofur Third Gen Ceph
Cephaguard Intramammary Cefquinome Fourth gen ceph
Cevaxel Injection Ceftiofur Third Gen Ceph
Cobactan Injection Cefquinome Fourth gen ceph
Cobactan Intramammary Cefquinome Fourth gen ceph
Coldostin Oral Solution Colistin Polymyxin
Colfive Oral Solution Colistin Polymyxin
Colibird Oral Solution Colistin Polymyxin
Coliplus Oral Solution Colistin Polymyxin
Coliscour Oral Solution Colistin Polymyxin
Colistin APSA In Feed Colistin Polymyxin
Curacef Duo Injection Ceftiofur Third Gen Ceph
Eficur Injection Ceftiofur Third Gen Ceph
Enrocare Injection Enrofloxacin Fluoroquinolone
Enrodexil Injection Enrofloxacin Fluoroquinolone
Enrotron Injection Enrofloxacin Fluoroquinolone
Enrotron Oral Solution Enrofloxacin Fluoroquinolone
Enrox Max Injection Enrofloxacin Fluoroquinolone
Enroxil Injection Enrofloxacin Fluoroquinolone
Enroxil Oral Solution Enrofloxacin Fluoroquinolone
Excenel Injection Ceftiofur Third Gen Ceph
Fenoflox Injection Enrofloxacin Fluoroquinolone
Forcyl Injection Marbofloxacin Fluoroquinolone
Hidrocol Oral Solution Colistin Polymyxin
Kelacyl Injection Marbofloxacin Fluoroquinolone
Lanflox Oral Solution Enrofloxacin Fluoroquinolone
Marbiflox Injection Marbofloxacin Fluoroquinolone
Marbim Injection Marbofloxacin Fluoroquinolone
Marbocare Injection Marbofloxacin Fluoroquinolone
Marbocyl Injection Marbofloxacin Fluoroquinolone
Marbocyl Bolus Marbofloxacin Fluoroquinolone
Marbonor Injection Marbofloxacin Fluoroquinolone
Marbosyva Injection Marbofloxacin Fluoroquinolone
Marbox Injection Marbofloxacin Fluoroquinolone
Masterflox Injection Marbofloxacin Fluoroquinolone
Naxcel Injection Ceftiofur Third Gen Ceph
Norotril Max Injection Enrofloxacin Fluoroquinolone
Pathocef Intramammary Cefoperazone Third Gen Ceph
Pathozone Intramammary Cefoperazone Third Gen Ceph
Plenix Intramammary Cefquinome Third Gen Ceph
Powerflox Injection Enrofloxacin Fluoroquinolone
Qivitan Injection Cefquinome Fourth gen ceph
Quiflor Injection Marbofloxacin Fluoroquinolone
Quinoflox Injection Enrofloxacin Fluoroquinolone
Quinoflox Oral Solution Enrofloxacin Fluoroquinolone
Readycef Injection Ceftiofur Third Gen Ceph
Spectron Oral Solution Enrofloxacin Fluoroquinolone
Unisol Injection Enrofloxacin Fluoroquinolone
Valemas Injection Enrofloxacin Fluoroquinolone
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