Since 2007, the public authorities have observed a resumption of the consumption of antibiotics in France, which had nevertheless significantly decreased since 2002. It remains one of the highest in Europe, behind that of Greece.
Most antibiotic prescriptions take place in winter, mostly in people over 15 years of age. Among them, active adults (30-65 years) and young parents express a strong demand, driven by the belief that antibiotics cure everything, immediately.
Wrongly prescribed against viruses
Antibiotics help fight bacteria, not viruses. Unfortunately, they are still mistakenly prescribed, especially for common illnesses that are usually viral, such as bronchitis or sore throat, which heal naturally.
If you have a viral illness, there is no need to harass your doctor to prescribe antibiotics, they will not relieve your symptoms, and you will not heal any faster. To relieve your sore throat or other discomfort, the doctor may prescribe other drugs, such as analgesics.
Antibiotics are irreplaceable drugs. Thanks to them, many operations can be possible, such as the fitting of prostheses (heart, hip), care for premature babies, cancer chemotherapy and transplants. It is therefore important to preserve their effectiveness in order to continue to be able to take charge of these operations and to treat certain diseases.
Each year, there are 10 million cases of acute bronchitis in France. And, contrary to popular belief, most often this bronchitis is caused by a virus. To treat it, the French Agency for the Safety of Health Products (Afssaps) does not recommend the use of antibiotics. Despite this, 76% of patients with acute bronchitis are prescribed antibiotics.
It is the same for tonsillitis: 90% of them are of viral origin in adults and 60 to 75% in children. In total, between 8 to 9 million viral tonsillitis occur each year. Even if, here again, Afssaps does not recommend the use of antibiotics, 66% of cases are treated with antibiotics.
General practitioners have at their disposal a rapid diagnostic test, the RDT, which allows them to know in a few minutes whether your angina is of viral or bacterial origin. Safe, effective and painless, it helps limit the risk of wrongly prescribed antibiotics.
The doctor takes secretions from the tonsil or pharynx with a swab (a kind of cotton swab). After dipping the sample in a tube containing a reagent, the doctor places a test strip in this same tube. If a blue line appears on the strip, there is streptococcus A beta hemolytic, a bacterium that causes angina. In this case, and only in this case, the doctor will prescribe antibiotics. If a red line appears, the angina is of viral origin and does not require antibiotic therapy.
Antibiotics cause bacteria resistance
Of course, bacteria have the ability to resist certain antibiotics. It is the phenomenon of resistance. A small part of the DNA of bacteria changes spontaneously, which gives them a property that they did not have before, such as resisting an antibiotic to which they were nevertheless sensitive before the mutation.
For example, imagine a group of bacteria sensitive to antibiotics from the fluoroquinolone family. Following a genetic event, a bacterium becomes resistant. Without intervention, this resistant bacteria naturally disappears. This is no longer the case in the presence of fluoroquinolones. If bacteria sensitive to this class of antibiotics are eliminated, those that resist it will stay in the body and proliferate. If another infection occurs, the fluoroquinolones will be ineffective because the majority of bacteria will have become resistant. This is what happened for pathologies involving the E.Coli bacteria (urinary tract infections).
The phenomenon of resistance is therefore dangerous for our body, but also for our relatives because it is transmitted, in particular in closed environments such as hospitals, the family circle …
Diseases increasingly difficult to cure
Following the first Medicare campaign “Antibiotics are not automatic”, but also thanks to hygiene measures and vaccination, the resistance of bacteria to pneumococcus and staphylococcus in the city has decreased. But efforts must continue. There is in fact an increase in resistance to antibiotics from other bacteria such as E. Coli bacteria. Treatment of urinary tract infection is becoming increasingly difficult, with 18% failure of antibiotic treatment in women over 65 years of age. Each year in the European Union, for lack of effective antibiotics, 25,000 patients die from an infection linked to multi-resistant bacteria.
– Recommendation “Systemic antibiotic therapy in upper and lower respiratory infections in adults and children”, French Agency for the Safety of Health Products (Afssaps), October 2005.
– National Observatory for the Epidemiology of Bacterial Resistance to Antibiotics, 2008: http://www.onerba.org/download/ONERBA_JNI09_poster.pdf
– Report of the European Center for Disease Prevention and Control (ECDC) “The bacterial challenge: time to react”