Title of the publicationSignificant Reduction of Antibiotic Use in the Community after a Nationwide Campaign in France, 2002–2007
Abstract

Background: Overuse of antibiotics is the main force driving the emergence and dissemination of bacterial resistance in the community. France consumes more antibiotics and has the highest rate of beta-lactam resistance in Streptococcus pneumoniae than any other European country. In 2001, the government initiated ‘‘Keep Antibiotics Working’’; the program’s main component was a campaign entitled ‘‘Les antibiotiques c’est pas automatique’’ (‘‘Antibiotics are not automatic’’) launched in 2002. We report the evaluation of this campaign by analyzing the evolution of outpatient antibiotic use in France 2000–2007, according to therapeutic class and geographic and age-group patterns.
Methods and Findings: This evaluation is based on 2000–2007 data, including 453,407,458 individual reimbursement data records and incidence of flu-like syndromes (FLSs). Data were obtained from the computerized French National Health Insurance database and provided by the French Sentinel Network. As compared to the preintervention period (2000–2002), the total number of antibiotic prescriptions per 100 inhabitants, adjusted for FLS frequency during the winter season, changed by 226.5% (95% confidence interval [CI] 233.5% to 219.6%) over 5 years. The decline occurred in all 22 regions of France and affected all antibiotic therapeutic classes except quinolones. The greatest decrease, 235.8% (95% CI 248.3% to 223.2%), was observed among young children aged 6–15 years. A significant change of 245% in the relationship between the incidence of flu-like syndromes and antibiotic prescriptions was observed.
Conclusions: The French national campaign was associated with a marked reduction of unnecessary antibiotic prescriptions, particularly in children. This study provides a useful method for assessing public-health strategies designed to reduce antibiotic use.

DOIhttps://doi.org/10.1371/journal.pmed.1000084
Name of the first authorSabuncu, Elifsu
Year of publication2009
Study design of the publicationTime-series analysis
Method for data collection and analysis
  • Quantitative data - Quantitative data were used during the intervention
Quantitative data - Quantitative data were used during the intervention
Scientific references about the intervention or other assessment of the intervention

Chahwakilian P, Huttner B, Schlemmer B, Harbarth S. Impact of the French campaign to reduce inappropriate
ambulatory antibiotic use on the prescription and consultation rates for respiratory tract infections.
J Antimicrob Chemother. 2011; 66(12):2872–9. https://doi.org/10.1093/jac/dkr387 PMID: 21965428

Dommergues MA, Hentgen V. Decreased paediatric antibiotic consumption in France between 2000
and 2010. Scand J Infect Dis. 2012; 44(7):495–501. https://doi.org/10.3109/00365548.2012.669840
PMID: 22497317

Bernier A, Delarocque-Astagneau E, Ligier C, Vibet MA, Guillemot D, Watier L. Outpatient antibiotic
use in France between 2000 and 2010: after the nationwide campaign, It Is Time To Focus on the
Elderly. Antimicrob Agents Chemother. 2014; 58(1):71–7. https://doi.org/10.1128/AAC.01813-13
PMID: 24126584

Sector
  • Human - All activities regarding organisations and individuals involved in health products and services
Sub-sectorSub-sectors are further units of demarcation within a sector E.g. awareness campaign from veterinarians to cat owners about toxoplasmosis drug resistance and transmission of resistant bacteria: ANIMAL, PETS
Subsector (human)
  • General (human health)
  • Healthcare delivery
General (human health)
Healthcare delivery