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.

• Quantitative data - Quantitative data were used during 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

• Human - All activities regarding organisations and individuals involved in health products and services

• General (human health)
• Healthcare delivery