European Congress of Clinical Microbiology and Infectious Diseases edition:14th location:Prague / Czech Republic date:May 1–4, 2004
To analyse the interventions undertaken by Belgian hospitals during a pilot phase of supporting local antibiotic managers (AM) and multidisciplinary antibiotic management teams (AMT).
In 2002–03, the Belgian government subsidised the part-time activities of AMs in 35 hospitals selected based on the presence of an operational AMT. The activities described in the first 8-month progress reports were analysed according to national guidelines for AMTs.
The pilot hospitals had a median capacity of 654 (range, 154–1597) beds; 18 hospitals comprised several sites. Their regional distribution was representative of population size, with 18 hospitals located in Flanders, 11 in Wallonia and six in Brussels; 17 were general hospitals, eight teaching hospitals and 10 general hospitals with teaching beds.
AMs were trained as internists (28), microbiologists (13) and hospital pharmacists (13). In 18 hospitals the AM also served as infection-control physician. On average, AMTs included 10 members who met every 6 weeks. The pilot financing scheme allowed the implementation of 175 antibiotic management interventions, with a mean of five interventions per hospital. More interventions were launched in large size and teaching hospitals. All hospitals irrespective of size or affiliation had undertaken a wide range of measures: review of formulary (29), implementation of new clinical guidelines (24), restricted access to select antibiotics (25), improvement of susceptibility-testing methods (12), development of antibiotic consumption database (35) and analysis of antibacterial susceptibility data (31). Updated guidelines addressed mainly urinary tract infection (14), pneumonia (14) and meningitis (10) and indications for use of specific drugs (14). Use of glycopeptides, carbapenems, fluoro-quinolones, cefepime and ceftazidime was restricted in respectively 16, 12, 12, 12 and 10 hospitals.
All hospitals that received financial incentive under the AMT pilot scheme have developed multiple antibiotic policy interventions independently of the hospital size and teaching status. Extension to all Belgian hospitals appears warranted. Further analysis is planned to monitor the impact of this scheme on the use of antibiotics and trends of antibiotic resistance.