The drug consumption level in France is often considered as being one of the most important in Europe. This study aims at confirming this assertion over the period 2000-2004 by comparing drug consumption in Germany, Spain, France, Italy and the United-Kingdom. The results show that in 2004 drug consumption in France was no more the biggest for all the seven studied classes. Moreover, the consumption levels of the five countries have converged between 2000 and 2004, as well as the consumption structures.
To assess time trends of outpatient antibiotic utilization using different measures and explore their discrepancies.Based on French sales data from the IQVIA SDM database, 2009-16, we assessed time trends in outpatient antibiotic utilization using PrID, DID, PID and SID (defined as the number of prescriptions, DDDs, packages and standard units per 1000 inhabitants per day, respectively). We explored discrepancies between trends in PrID and DID by modelling the number of DDDs per prescription.Outpatient antibiotic utilization (n = 538.2 million projected prescriptions) decreased in terms of PrID, PID and SID (-10%, -8% and -8%, respectively; negative regression slopes; P < 0.01), but remained stable according to DID (+2%; slope 0.009; P = 0.4). The number of DDDs per prescription increased over time (+14%; slope 0.019; P < 0.001). The proportions of amoxicillin and amoxicillin/clavulanate were positively associated with the number of DDDs per prescription (adjusted coefficients 0.10 and 0.15, respectively; both P < 0.05), as well as the proportion of adult and hospital prescriptions (adjusted coefficients 0.07 and 0.05, respectively; both P < 0.05). The discrepancy between DID and PrID disappeared when the DDD of amoxicillin was increased to values higher than the current DDD.Time trends in outpatient antibiotic utilization expressed as PrID, DID, PID and SID provided conflicting results. We caution against using DID alone when monitoring antibiotic utilization. Instead, we recommend monitoring both DID and PrID as they provide different types of relevant information, especially when studying trends at a national level.
To assess recent community antibiotic prescribing for French children and identify areas of potential improvement.We analysed 221 768 paediatric (<15 years) visits in a national sample of 680 French GPs and 70 community paediatricians (IQVIA's EPPM database), from March 2015 to February 2017, excluding well-child visits. We calculated antibiotic prescription rates per 100 visits, separately for GPs and paediatricians. For respiratory tract infections (RTIs), we described broad-spectrum antibiotic use and duration of treatment. We used Poisson regression to identify factors associated with antibiotic prescribing.GPs prescribed more antibiotics than paediatricians [prescription rate 26.1 (95% CI 25.9-26.3) versus 21.6 (95% CI 21.0-22.2) per 100 visits, respectively; P < 0.0001]. RTIs accounted for more than 80% of antibiotic prescriptions, with presumed viral RTIs being responsible for 40.8% and 23.6% of all antibiotic prescriptions by GPs and paediatricians, respectively. For RTIs, antibiotic prescription rates per 100 visits were: otitis, 68.1 and 79.8; pharyngitis, 67.3 and 53.3; sinusitis, 67.9 and 77.3; pneumonia, 80.0 and 99.2; bronchitis, 65.2 and 47.3; common cold, 21.7 and 11.6; bronchiolitis 31.6 and 20.1; and other presumed viral RTIs, 24.1 and 11.0, for GPs and paediatricians, respectively. For RTIs, GPs prescribed more broad-spectrum antibiotics [49.8% (95% CI 49.3-50.3) versus 35.6% (95% CI 34.1-37.1), P < 0.0001] and antibiotic courses of similar duration (P = 0.21). After adjustment for diagnosis, antibiotic prescription rates were not associated with season and patient age, but were significantly higher among GPs aged ≥50 years.Future antibiotic stewardship campaigns should target presumed viral RTIs, broad-spectrum antibiotic use and GPs aged ≥50 years.
ObjectivesTo assess long-term trends in the volume of ambulatory antibiotic prescriptions and prescription and consultation rates for respiratory tract infections (RTIs) in France in relation to the yearly public antibiotic campaign since 2002.
