Article # 7:
Title: Significant Reduction of Antibiotic Use in the Community
after a Nationwide Campaign in France, 2002–2007
Aim of Intervention:
To reduce the inappropriate use of antibiotics, particularly for the
treatment of viral infections among children.
Target Population:
French population
Target Place: France
Time Period: 2002 to 2007 during the winter months when
viral infections mainly occur.
Intervention Tool(s):
The campaign included an educational campaign for health care workers, the
promotion of rapid tests for diagnosis of streptococcal infections, and a
public information campaign about VRIs and about antibiotic resistance. In this
study, the researchers evaluate the campaign by analyzing outpatient antibiotic
use throughout France from 2000 to 2007.
Technology: Access to
French National Health Insurance database and national disease surveillance
system. Analyses were performed using SAS version 9.1 (SAS Institute).
Results: The
number of antibiotic prescriptions per 100 inhabitants decreased by a quarter
over the five winters of the “Antibiotics are not automatic” campaign. The
greatest decrease in prescription rate (a decrease of more than a third by
2006/7) was among children aged 6–15 years. Finally, although the rates of
antibiotic prescriptions reflected the rates of flu-like illness throughout the
campaign, by 2006/7 this relationship was much weaker, which suggests that
fewer antibiotics were being prescribed for viral infections.
Costs: Estimated to
cost 500 million euros over six years. No external funds were obtained for this
work. It was supported directly by internal resources of the INSERM, Pasteur Institute,
the French NHI, and Assistance Publique Hopitaux de Paris. The funders had no
role in study design, data collection and analysis, decision to publish, or
preparation of the manuscript.
Personal Reflection: Costly,
requires heavy funding and national support, needs close scrutinization and
ongoing evaluation over long-term period. Promising results.
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