In France, antibiotics tend to become a little too automatic again

Antibiotic consumption increased in 2022

“If the consumption of antibiotics remains generally on a downward trend since 2012, it increased in 2022 at a more sustained rate than in 2021“, according to an annual study by Public Health France (SPF) based on reimbursements of prescriptions by health insurance, published in the run-up to the global week for the proper use of antibiotics (November 18).

The increase is obvious, both in prescriptions and in doses consumed in town (excluding hospitals): +16.6% over one year in the first case (with more than 800 antibiotic prescriptions per 1,000 inhabitants in the year), and + 14% in the second case (with 21.6 doses per 1,000 inhabitants per day).

While “the Covid pandemic had shown a break in the curve“, Laëtitia Gambotti, head of the healthcare-associated infections and antibiotic resistance unit at Public Health France, noted to AFP “a two-year rise in consumption, returning to 2019 levels“.

“We had a small hope that the decline observed in 2020 could be sustained, or at least that we would keep something, but, as in other European countries, this was not the case.“, commented Dr Anne Berger-Carbonne, another specialist from the health agency.

A more marked increase among the youngest

The year 2020 remains unique: strict anti-Covid measures (lockdowns, barrier gestures) had reduced the frequency of bacterial infections but also access to care.

“2021 and 2022 were accompanied by a resumption of common winter infections, medical consultations and antibiotic prescriptions, particularly in their last quarters“, pointed out SpF.

This rise “however remains at a level slightly lower than that observed in 2019“, before the Covid pandemic, nuanced the agency.

“Important” in children, the consumption of antibiotics in these young patients has returned in 2022, or even exceeded, the pre-pandemic level.

“The increase is greater among 0-14 year olds, populations more prone to winter epidemics“, noted Laëtitia Gambotti.

However, the 2022-2023 season was marked by a triple epidemic of influenza-bronchiolitis-Covid, but also other pathologies – although partly viral – which influenced the consumption of antibiotics, especially at the end of the year.

The flu fueled an epidemic”exceptionally long and early“, bronchiolitis has reached an amplitude”very significantly higher than in previous years“, acute gastroenteritis has returned to levels comparable to those before the pandemic, observed SpF.

One of the five worst European students

In addition to age groups, antibiotic consumption varies according to region, where disparities have been generally stable for around ten years. Corsica and Provence-Alpes-Côte d’Azur appear as the most users, Pays de la Loire and the overseas departments as the least consumers.

But, overall, “France remains one of the top five European countries with the highest consumption of antibiotics“, noted Laëtitia Gambotti.

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.

However, antibiotic resistance, which has worried global health authorities for years due to its deadly consequences, is exacerbated by excessive or inappropriate consumption of these treatments.

Reducing the consumption of antibiotics is an objective of health authorities, in France and in other countries, to slow down the appearance of resistant bacteria. “Otherwise the risk, in the long term, is that we no longer have the therapeutic arsenal for certain bacterial diseases, which can cause mortality, particularly among the most vulnerable.“, recalled Laëtitia Gambotti.

To raise awareness again, SPF will rebroadcast, from December, a campaign on the proper use of antibiotics (“taking good care of yourself means first using them well”), effective only against bacterial infections, of no interest against viral infections such as bronchiolitis or the flu.

For Anne Berger-Carbonne, “we have to wait until 2023 to see where we are in efforts to reduce antibiotic consumption“.