Antibiotics for typhoid fever. Essential Medicine List Application for Special Indication: Typhoid and Paratyphoid Fever Review of Antibacterial Medicines for the Treatment of Enteric Fever for the WHO Model List of Essential Medicines 2019 Update

The WHO Essential Medicine List (EML) lists the most efficacious and safe medicines, including antibiotics to treat illnesses that are considered high priority. The 20th EML, published in 2017, provided new guidance to optimise antibiotic use for many common infections and categorised antibiotics into three groups: ACCESS, WATCH, RESERVE. The choice of an effective antibiotics to treat patients is an important tool in the fight against antimicrobial drug resistance (AMR) and is part of the WHO Global Action Plan. The aim of this proposal is to add enteric fever as new indication for selected antibiotics included in the Essential Medicines List. We performed systematic reviews to evaluate the safety and efficacy of antibiotics that are recommended in national and international enteric fever treatment guidelines following the process outlined in the Guideline Development Handbook. We believe that special attention should be paid to the impact of drug resistance on treatment, and the impact of sub-optimal treatment on individuals and on secondary transmission in the community. It needs to be noted that the patterns of antimicrobial susceptibilities can differ from place to place and over time, and that knowledge about local resistance patterns is necessary to inform empiric treatment. Surveillance and sharing of antimicrobial resistance data is critical in order to combat resistance and to inform the correct choice of antibiotic treatment.