MIBAC: Antibiotic use in the community

About

Since 2002 a centralized storage of therapeutic or preventive medications of bacterial infections in the community (MIBAC) has been initiated. Reimbursements for all systemic antibiotics (class J01 of the Anatomical Therapeutic classification), as well as for pneumococci vaccine are included. Ten years of data have been gathered (2000–2010) and all French individuals affiliated with the French National Bureau of Health Insurance for Salaried Workers (CNAMTS) or the RSI (“Régime social des indépendants”, for self-employed workers) were covered. Recently, extraction from SNIIRAM/SNDS has been enabled for 2006-2026 (CNIL – 19044978/948387 – DE-2015-190/DR-2018-311) including beneficiaries of the MSA (“Mutualité Sociale Agricole”) in addition to the other two healthcare reimbursement systems.

To our knowledge, the database we have gathered is unique. The material analyzed corresponds to the various routes by which reimbursement for antibiotics could be requested from these insurers, who represent circa 90% of the French population. These include: the specialty of the practitioner who prescribed the antibiotic, the anatomical therapeutic chemical (ATC) classification, the CIP (“Club Inter-Pharmaceutique”) code of the antimicrobial agent which is a unique code for the drug presentation, the number of boxes delivered, the prescription and delivery dates, the gender, the year of birth, the geographic location (department, a French administrative area) and the health insurance system of the person to whom the antibiotic was prescribed. From 2006 onwards, reimbursements of a single individual can be retrieved within the database.

Research issues arise on (a) the frequency of individual exposures to antibiotics, with some groups of the population possibly consuming few antibiotics compared to others; (b) the recurrence of antibiotics taken at extreme ages of life; (c) the link between consumption and comorbidities, etc.