[Medical economics and optimal antibiotic therapy]

Antibiotics account for a large proportion of pharmaceutical consumption in France and in the world. Forty years after penicillin was introduced in antimicrobial therapy, the antibiotics constitute the first pharmaceutical class in the world (gross production) with beta-lactam antibiotics at the top. The sociological and economical consequences of their development are considerable: decrease in death-rates in childhood, tuberculosis healing, life lengthening, etc.: the consequences of these improvements on health organisation and structures are difficult to evaluate in terms of economics. The drawbacks of the development of antibiotic therapy besides side-effects or toxicity, are the emergence of resistant strains as a consequence of selective pressure due to uncontrolled use of antibiotics; the expenses increase in hospitals in relation to indiscriminate use of chemotherapeutic agents. For an optimal antibiotic therapy, a rational prescription of antibiotics and a control of appropriate antibiotic usage should be developed. However, the therapeutic efficacy and patients' cure constitute the main objective of an optimal antibiotic therapy.