“After two consecutive years marked by an increase in the use of antibiotics, the 2023 figures are part of the trend of moderate but constant decline observed before the Covid-19 pandemic, since 2013”, according to an annual study published by Public Health France from reimbursements of prescriptions by health insurance.
This development is perceptible in prescriptions (820.6 per 1,000 inhabitants in the year, i.e. -0.2% compared to 2022) and in consumption (-3.3% over one year of daily doses per 1,000 inhabitants ). After a downward trend for several years and a fall in antibiotic consumption at the start of the Covid pandemic, a recovery appeared in 2021 and intensified in 2022.
Strong disparities
“We are returning to a normal post-pandemic health situation and education among professionals and patients is gradually bearing fruit, but efforts for the controlled use of antibiotics remain relevant,” declared Laëtitia Gambotti, head of the infections unit. associated with care and antibiotic resistance from Public Health France, in the run-up to Global Antimicrobial Resistance Awareness Week (November 18 to 24).
Because if the decline in 2023 is “an encouraging sign”, France is “still far from the target objective of less than 650 prescriptions per 1,000 inhabitants per year” by 2025, also recalled Dr Caroline Semaille, director general of the health agency, cited in a press release. France remains one of the top five European countries with the highest consumption of antibiotics.
A specificity linked to practices and a history of the medicinal approach different from other countries, but also to a cultural dimension of the prescription of antibiotics. In France, in 2023, disparities in prescriptions and use also remained “strong depending on age, sex and territories”, noted Public Health France.
More important in women
In the good news: “the return of children under five to prescriptions even slightly lower than the 2019 level, better than expected, after the sharp increase in 2022,” noted Laëtitia Gambotti. Conversely, “among those over 65, and even more so among those over 80, there was a slight increase,” she pointed out.
Consumption also remained generally higher among women than among men, and in certain regions, such as Corsica and PACA. If general practitioners remain the most prescribers of antibiotics, they used them less in 2023 (-1.3% over one year), unlike specialists (+ 4.6%) and dentists (+ 1.4 %).
Reducing the consumption of antibiotics is an objective of the health authorities, in France and in other countries, to slow down the appearance of bacteria resistant to these molecules. However, the three families of antibiotics most administered in 2023 (amoxicillin, combination of amoxicillin and clavulanic acid, macrolides) are “strongly generating resistance”, warned Public Health France, calling for their prescription to be restricted.
Public health threat
To avoid wrongly administering antibiotics, rapid diagnostic orientation tests (Trod) have also made it possible in recent years to confirm the bacterial nature of tonsillitis and urinary infections. If antibiotic resistance is natural, it is exacerbated by excessive or inappropriate consumption of treatments, for example against seasonal flu, of viral and non-bacterial origin.
The World Health Organization (WHO) depicts it as one of the main global public health threats, already leading to around 1.3 million deaths each year. While antibiotics have revolutionized modern medicine, their reduced effectiveness complicates the treatment of often deadly bacterial diseases, such as tuberculosis or a number of pneumonias, and increases the risks of infections in vulnerable patients, in the case of cancer for example.
