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     <dc:title xml:lang="fr">Pénuries d’antibiotique (amoxicilline, pénicillines M et rifampicine) : causes, conséquences et politiques de gestion de ces pénuries</dc:title>
     <dcterms:alternative xml:lang="en">Antibiotic Shortages (Amoxicillin, Penicillinase-Resistant Penicillins, and Rifampicin): Causes, Consequences, and Management Policies</dcterms:alternative>
     <dc:subject xml:lang="fr">Pénuries</dc:subject><dc:subject xml:lang="fr">Antibiotiques</dc:subject><dc:subject xml:lang="fr">Amoxicilline</dc:subject><dc:subject xml:lang="fr">Pénicillines M</dc:subject><dc:subject xml:lang="fr">Rifampicine</dc:subject><dc:subject xml:lang="fr">Résistance bactérienne</dc:subject><dc:subject xml:lang="fr">Production</dc:subject><dc:subject xml:lang="fr">pharmaceutique</dc:subject><dc:subject xml:lang="fr">Souveraineté sanitaire</dc:subject><dc:subject xml:lang="fr">Gestion des stocks</dc:subject><dc:subject xml:lang="fr">Politiques de santé publique</dc:subject><tef:sujetRameau><tef:vedetteRameauNomCommun>
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     <dcterms:abstract xml:lang="fr">Cette thèse analyse les pénuries d’antibiotiques (amoxicilline, pénicillines M, rifampicine) sous l’angle de leurs causes, conséquences et des politiques de gestion. Ces médicaments essentiels subissent des tensions croissantes dues à la concentration de la production, la dépendance aux pays tiers, la faible rentabilité et des contraintes réglementaires. Les pénuries impactent la qualité des soins, favorisent les résistances bactériennes et complexifient la pratique médicale. Face à ce constat, des stratégies sont déployées en France, en Europe et à l’international : plans de gestion, stocks de sécurité, relocalisation partielle de la production. L’objectif est de garantir un accès équitable et pérenne aux traitements, en renforçant la souveraineté sanitaire et la coordination entre les acteurs du médicament.</dcterms:abstract>
     <dcterms:abstract xml:lang="en">This thesis analyzes antibiotic shortages (amoxicillin, penicillinase-resistant penicillins, rifampicin) through the lens of their causes, consequences, and management policies. These essential medicines are facing increasing pressure due to the concentration of production, dependence on third countries, low profitability, and regulatory constraints. Shortages affect the quality of care, promote bacterial resistance, and complicate medical practice. In response, strategies are being implemented in France, Europe, and internationally: management plans, safety stocks, and partial relocation of production. The objective is to ensure equitable and sustainable access to treatments by strengthening health sovereignty and improving coordination among pharmaceutical stakeholders.</dcterms:abstract>
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