title: Impact of the French campaign to reduce inappropriate ambulatory antibiotic use on the prescription and consultation rates for respiratory tract infections.
abstract: OBJECTIVE
  To 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.
  
  
  METHODS
  Data collected on representative cohorts of office-based physicians and pharmacies in France participating in IMS Health panels between 1980 and 2009 were analysed retrospectively. Main outcome measures were antibiotic prescriptions per 1000 inhabitants per year (PIY), consultations per 1000 inhabitants per year and proportion of consultations resulting in antibiotic prescriptions.
  
  
  RESULTS
  The peak in ambulatory antibiotic prescriptions occurred in 1997 (1468 PIY). Although prescriptions had decreased by 6% until 2001, prescriptions fell sharply (-22%) between 2001 and 2004, followed by stable prescription rates until 2009. The 2001-09 decrease in antibiotic prescriptions was driven by a sharp decline in office-based antibiotic prescriptions (-33%), exclusively achieved through a decrease in prescriptions for RTIs. Consultations for RTIs steadily declined between 2001 and 2009 (-23%), with the proportion of consultations resulting in antibiotic prescriptions decreasing from 58% to 46%. Not all types of RTIs were equally affected. The largest decrease in prescriptions was observed for nasopharyngitis and influenza. Rates for bronchitis, sinusitis, otitis media and tonsillitis remained persistently high.
  
  
  CONCLUSIONS
  During its first 3 years, the French public campaign accelerated a pre-existing decrease in ambulatory antibiotic prescriptions. The decrease in consultation rates suggests that altered illness behaviour of patients may have contributed to the observed decline. The persistently high prescribing rates for certain RTIs show that further effort is needed to improve antibiotic prescribing in France.
authors.affiliation: Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Chahwakilian
authors.forename: Benedikt
authors.initials: B
authors.lastname: Huttner
authors.forename: Benoit
authors.initials: B
authors.lastname: Schlemmer
authors.forename: Stephan
authors.initials: S
authors.lastname: Harbarth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods* / Q000592:standards*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004358:Drug Therapy / Q000592:standards*; D004363:Drug Utilization / Q000592:standards* / Q000706:statistics & numerical data; D005602:France; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D055656:Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents