Les jeunes Français, notamment ceux âgés de moins de 6 ans, ingurgiteraient beaucoup trop de médicaments. C’est ce qui a été constaté à l’occasion d’une étude, publiée lundi 12 juillet. Des « résultats préoccupants », selon les spécialistes qui se sont prononcés à ce sujet, puisque « les enfants les plus jeunes sont particulièrement vulnérables aux effets indésirables à court et à long terme des médicaments ». Les experts revendiquent une meilleure information de la population et des prescripteurs de médicaments.
« La France est l’un des pays les plus prescripteurs de médicaments en pédiatrie ambulatoire » – c’est-à-dire hors hôpital –, même s’il faut être prudent dans ces comparaisons car « les systèmes de santé et les politiques de remboursement des médicaments diffèrent entre les pays », souligne dans un communiqué l’institut de recherche Inserm. « De plus, le profil de sécurité [les éventuels risques et effets indésirables, NDLR] de nombreux médicaments utilisés en pédiatrie n’est que partiellement connu », ajoute l’Inserm.
Trop de corticoïdes
Publiée dans la revue The Lancet Regional Health Europe, cette étude se penche sur ce type de prescriptions en 2018-2019, comparativement à 2010-2011, sur la base des données de remboursement par la Sécurité sociale. Elle porte sur les médicaments remboursés prescrits aux moins de 18 ans, hors hospitalisation, par un médecin, une sage-femme ou un dentiste. Au total, pour 2018-2019, plus de 230 millions de prescriptions de médicaments ont été analysées.
Sur cette période, « en moyenne, 86 enfants de moins de 18 ans sur 100 ont été exposés à au moins une prescription médicamenteuse au cours d’une année », soit « une augmentation de 4 % par rapport à 2010-2011 », selon l’Inserm. « Les enfants de moins de 6 ans représentaient la catégorie des enfants la plus exposée aux médicaments avec plus de 97 enfants sur 100 concernés sur une année. » En outre, « un enfant de moins de 6 ans sur trois a reçu une prescription de corticoïdes oraux », un niveau stable depuis 2010-2011 « malgré les effets indésirables connus ».
Les familles de médicaments les plus prescrites sont les analgésiques (64 % des mineurs en ont eu), les antibiotiques (40 %), les corticoïdes par voie nasale (33 %), la vitamine D (30 %), les anti-inflammatoires non stéroïdiens (24 %), les antihistaminiques (25 %) et les corticoïdes par voie orale (21 %). Conformément aux recommandations officielles, l’étude note « une diminution de 12 % de la fréquence de prescriptions d’antibiotiques sur les dix dernières années ». Mais cela reste « insuffisant car plus d’un enfant de moins de 6 ans sur deux a reçu une prescription d’antibiotiques dans l’année », peut-on lire.
Une image positive des médicaments
Les chercheurs estiment que « ces niveaux élevés de prescriptions pourraient s’expliquer notamment par l’image positive qui est associée aux médicaments en France, tant dans la population que parmi les prescripteurs ». « Dans les autres pays à économie avancée, il existerait un rapport plus conscient de la balance bénéfice-risque des médicaments », jugent-ils. Ainsi, « les fréquences de prescriptions de corticoïdes par voie orale pour les enfants français étaient (respectivement) 5 et 20 fois plus élevées que celles observées pour des enfants américains et norvégiens dans d’autres études récentes ». Et, « pour les antibiotiques, la fréquence de prescriptions aux enfants français était 5 fois supérieure à celle observée aux Pays-Bas ».
Source: lepoint
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