Antibiotics for babies: what the 2024 data show
Antibiotics help babies fight bacterial infections, but they do nothing against viral ones. And viral infections account for most illnesses in early childhood: colds, bronchiolitis, flu, most sore throats before age 3 and most stomach bugs. On 18 November 2025, Santé publique France (the French public health agency) published its 2024 report on antibiotic use in community care. Prescriptions are rising again across the general population. Children aged 0 to 4 remain the most exposed age group, with 1,326 prescriptions per 1,000 children per year. This article brings those figures together, explains when an antibiotic is justified for a baby, and sets out what the health authorities recommend to parents.
The Santé publique France figures for 2024
The annual report, produced with the Assurance Maladie (French national health insurance) and the Agence nationale de sécurité du médicament (the French medicines regulator), covers antibiotics dispensed in community care, outside hospital. The main findings:
- More than 860 prescriptions per 1,000 inhabitants in 2024, up 4.8 % on 2023.
- 22.1 defined daily doses per 1,000 inhabitants per day, up 5.4 %, a level comparable to 2019, before the pandemic.
- Among children aged 0 to 4, 1,326 prescriptions per 1,000 children per year, a stable figure, slightly below 2019 (1,333).
- The number of prescriptions for children rose particularly sharply in the third quarter of 2024, linked to a strong wave of winter infections. Santé publique France points out that these infections are mostly viral and should not lead to an antibiotic prescription.
- GPs account for 75.6 % of the volume prescribed, other specialists 12.2 % and dentists 11.9 %.
- Penicillins, including amoxicillin, remain the most prescribed class, making up more than half of all prescriptions; their prescription rose by 18.9 % in 2024.
According to these data, France is still the second-highest consumer of antibiotics in Europe. The national strategy for preventing infections and antimicrobial resistance sets a target of 650 prescriptions per 1,000 inhabitants by 2027. The gap between that and the 860 measured in 2024 shows how much effort is still needed.
Why are 0 to 4-year-olds the most exposed?
A baby has on average six to ten respiratory infections a year, and more at nursery. Every episode means a visit to the doctor, and so a chance of a prescription. Fever is worrying, nights are short, and the pressure to ‘give something’ is real on both sides of the desk. Yet almost all of these episodes are viral. The figure of 1,326 prescriptions per 1,000 children means that a child under 5 receives, on average, more than one course of antibiotics a year. Our article on how often children get ill at nursery describes this pattern of infections.
When is an antibiotic useful for a baby?
The rule is simple to state: an antibiotic works on bacteria, never on viruses. As the Assurance Maladie reminds us, antibiotics cannot cure viral illnesses. The difficulty is that a fever, a cough and a runny nose do not tell you by themselves whether a virus or a bacterium is to blame. It is the medical examination, sometimes backed up by a test, that settles the question.
Infections that do not call for antibiotics
- Colds (nasopharyngitis): according to the Assurance Maladie, they clear up on their own in under ten days and are treated with nasal rinses and nose-blowing. Our guide to the baby nasal aspirator explains how to use one.
- Bronchiolitis: viral in the vast majority of cases, it is not treated with antibiotics. Our article on bronchiolitis and how to prevent it covers the recommendations.
- Flu, whose 2026-2027 vaccination campaign opens on 13 October: see our article on flu in babies.
- Sore throat (tonsillitis) before age 3: the Assurance Maladie states that in children under three, treatment to relieve fever and pain is enough. The rapid test is only carried out from age 3; if it is positive, the sore throat is bacterial and an antibiotic becomes necessary.
- Acute bronchitis and most stomach bugs, also listed by the Assurance Maladie among viral infections.
Situations where an antibiotic is justified
Some bacterial infections are common in babies and respond well to treatment: urinary tract infections, some types of pneumonia, widespread impetigo and scarlet fever. Then there is acute middle ear infection before age 2, for which the Haute Autorité de santé (the French national authority for health) has set out prescribing rules according to age. We look at ear infections in detail in our article on ear infections in babies. In a baby under 3 months, any fever is an emergency that may lead to antibiotic treatment in hospital while a serious infection is ruled out. Our article on fever in babies explains these thresholds.
Why avoid an unnecessary antibiotic for a baby?
There are three reasons, all documented by the health authorities. The first is that there is no benefit: with a viral infection, an antibiotic neither shortens the illness nor prevents complications. The second is the effect on the child: digestive upsets, skin reactions and disruption of the gut flora, which is still developing during the first years of life. The third is collective: every exposure selects resistant bacteria. The Assurance Maladie puts the burden of antimicrobial resistance in France at 125,000 infections and more than 5,500 deaths attributed to multidrug-resistant bacteria.
What can parents do?
The Assurance Maladie's guidance on using antibiotics properly applies to babies just as it does to adults:
- Never give an antibiotic without a prescription, and never reuse what is left in a bottle from a previous course, even for symptoms that seem the same.
- When an antibiotic is prescribed, stick to the dose, the timings and the full length of the course, without stopping as soon as symptoms improve.
- Take opened or unused bottles back to the pharmacy.
- Do not ask for an antibiotic for a cold or bronchiolitis: the fever needs to be monitored and relieved. Our article on paracetamol doses by weight and our guide to choosing a thermometer cover this side of things.
- Reduce the chances of infection: handwashing, airing rooms, keeping smokers away, vaccinations according to the schedule.
It is perfectly reasonable to ask the doctor why they are, or are not, prescribing an antibiotic. An appointment that ends with ‘it's viral, let's keep an eye on it’ is not a wasted appointment: it is the expected outcome in the vast majority of cases.
Antibiotics and babies: frequently asked questions
My baby has had a fever for three days. Do they need an antibiotic?
Not necessarily. A viral fever often lasts three to five days. What matters is the child's general condition, their age, any warning signs and the doctor's examination. Under 3 months, see a doctor straight away, however long the fever has lasted.
The doctor didn't prescribe anything. Is that normal?
Yes, in most appointments for a respiratory infection in a baby. The 2024 data show that the peak in prescriptions for children coincides with mostly viral winter infections, which is exactly what Santé publique France flags as something to correct.
Should probiotics be given with the antibiotic?
No official French recommendation requires them for babies. Ask your doctor or pharmacist for advice rather than buying a product at random.
Key takeaways
- In 2024, children aged 0 to 4 received 1,326 antibiotic prescriptions per 1,000 children, making them the most exposed age group.
- The rise seen in children in the third quarter of 2024 involves mostly viral infections, for which antibiotics are not indicated.
- Colds, bronchiolitis, flu, sore throat before age 3, bronchitis, stomach bugs: no antibiotic.
- Ear infection before age 2, urinary tract infection, bacterial pneumonia, fever under 3 months: an antibiotic may be justified, on medical advice.
- Never self-medicate, finish the full course when one is prescribed, take leftovers back to the pharmacy.
Sources
- Santé publique France, “Les prescriptions et la consommation d'antibiotiques en secteur de ville augmentent en 2024”, press release, 18 November 2025.
- Vidal, “Consommation d'antibiotiques en France : une hausse significative en 2024”, 20 November 2025 (reporting data from Santé publique France, ANSM and the Assurance Maladie).
- Assurance Maladie (ameli.fr), “Antibiotiques et antibiorésistance”, updated 22 July 2026.
- Assurance Maladie (ameli.fr), “Traitement de la rhinopharyngite de l'enfant”, updated 4 February 2026.
- Assurance Maladie (ameli.fr), “Traitement de l'angine avec ou sans antibiotiques”, updated 4 September 2026.
