Appendix 1—table 8. Antibiotic classes, their contribution to total hospital antibiotic consumption, their spectrum, and their relative rate of inducing microbiome dysbiosis.

Consumption data come from the French ANSM and are supplemented with data from Baggs et al. (Agence nationale de sécurité du médicament et des produits de santé, 2017; Baggs et al., 2016). The literature was used to classify antibiotic classes in terms of their spectrum, (Abbara et al., 2020; Tan et al., 2017) and relative rate of causing microbiome dysbiosis. (Baggs et al., 2018; Brown et al., 2013) The percentage column does not total to 100 due to rounding error.

Antibiotic class	ACT code	% of consumption	Spectrum	Rate of inducing microbiome dysbiosis
Amoxicillin and beta-lactamase inhibitor	J01CR02	32.4	Broad	High
Penicillins with extended spectrum	J01CA	21.9	Narrow	Medium
Quinolones	J01M	11.0	Broad	High
C3G	J01DD	8.2	Broad	Very high
C1G	J01DB	3.7	Narrow	High
Macrolides	J01FA	3.4	Narrow	Medium
Imidazole	J01XD	2.9	Narrow	Medium
Piperacillin and beta-lactamase inhibitor	J01CR05	2.3	Broad	High
Aminoglycosides	J01G	2.3	Narrow	Low
Tetracyclines	J01A	2.0	Narrow	Low
Sulfonamides, trimethoprim	J01E	1.8	Narrow	Medium
Glycopeptides	J01XA	1.8	Narrow	Very high
Lincosamides	J01FF	1.6	Broad	Very high
Carbapenems	J01DH	1.5	Broad	High
Penicillins (other)	J01C_other	1.4	Narrow	Medium
C2G	J01DC	0.9	Narrow	High
C4G	J01DE	0.6	Broad	Very high
Other	Other	2.1	Narrow	Medium