The French still consume too many antibiotics

Posted Nov 18, 2022 11:08 AMUpdated Nov. 18, 2022, 1:15 p.m.

The French consume less and less antibiotics. This is the observation drawn up by Santé Publique France (SPF) in a study published this Friday, on the occasion of the European Antibiotic Information Day. Efforts must however be maintained, because too much is still consumed.

Between 2011 and 2019, the number of antibiotic prescriptions fell by an average of 2.4% each year. After falling sharply in 2020, in particular due to the Covid-19 pandemic, the consumption of antibiotics started to rise again in France in 2021, especially among children, while remaining overall below 2019 levels.

Objectives not achieved

However, the objectives set by the authorities have not yet been achieved. In 2021, approximately 700 antibiotic prescriptions were written per 1,000 inhabitants. Above the 650 prescriptions per year for 1,000 inhabitants targeted by the national strategy.

In terms of defined daily dose (DDD) – the reference dosage set by the WHO for an adult – France is also above the objectives. Consumption in France stands at 21.5 DDD per 1,000 inhabitants per day. The target set by the national strategy is 20. Thus, in 2020, France remained the fourth country that consumes the most antibiotics in Europe, behind Greece, Romania and Bulgaria.

Consumption on the rise in dogs and cats

In animal health, progress has also been made. Between 2011 and 2021, animal exposure to antibiotics decreased by 47% in France.

This decrease concerns all animal species. It is greater for species whose products are intended for human consumption. Since 2011, exposure to antibiotics has thus decreased by 67.9% for poultry, 58.5% for pigs, 44.7% for rabbits and 23% for cattle, ANSES said on Wednesday.

Most European countries have moved in the same direction. Between 2011 and 2020, the quantities of antibiotics sold at European level fell by 43.2% SPF note.

On the other hand, the exposure to antibiotics of cats, dogs and horses has increased. After a 19.5% drop between 2011 and 2016, the level of exposure of cats and dogs has increased in recent years, returning to a level close to 2011.

Reduced use of critical antibiotics

The authorities encourage reducing the use of antibiotics in humans and animals to avoid the development of bacteria resistant to treatment (antibiotic resistance). In its report, SPF notes improvements on the subject. Thus, the common indicator of the resistance of strains of Escherichia coli – an intestinal bacterium – to cephalosporins – a class of antibiotic – is decreasing, in cities, in establishments for dependent elderly people, in health establishments as well as in health animal.

In addition, the indicators of consumption of critical antibiotics, namely those which are particularly generators of bacterial resistance and those which are of particular interest in so-called treatment of last resort, are falling. In city medicine, their share increased from 46% in 2011 to 55% in 2019.

There are points for improvement. In the city, resistance to fluoroquinolones – a type of antibiotic – has been increasing since 2019. In addition, none of the indicators of the national strategy reach the target set for each year. Public Health France recalls that the proper use of antibiotics is based in particular on careful and responsible use.

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