van Gastel E.,Belgian Antibiotic Policy Coordination Committee BAPCOC |
Costers M.,Belgian Antibiotic Policy Coordination Committee BAPCOC |
Peetermans W.E.,University Ziekenhuizen Leuven Gasthuisberg |
Struelens M.J.,Free University of Colombia
Journal of Antimicrobial Chemotherapy | Year: 2010
Objectives: Antibiotic management teams (AMTs) have been advocated to optimize the use of antimicrobials in hospitals. Since 2002, the Belgian Antibiotic Policy Coordination Committee (BAPCOC) has supported the development of AMTs in Belgian hospitals with policy guidance and federal funding for antibiotic managers. We performed a national, self-reporting survey to assess the level of AMT activities in 2007. Methods: A structured questionnaire survey was performed on the composition, organization and service activities of the AMT in all acute care and larger chronic care hospitals in the country in 2007. Descriptive statistics were stratified by duration of AMT funding. Results: Completed questionnaires were provided by 112 of 116 hospitals (response rate, 96.6%). Mutidisciplinary AMTs varied in size (mean 10, range 2-28 members). Antibiotic stewardship tools used by AMTs included: hospital antibiotic formulary (96.3% of hospitals); practice guidelines for antibiotic therapy and surgical prophylaxis (91.6% and 96.3%, respectively); list of 'restricted' antimicrobial agents (75.9%); concurrent review of antibiotic therapies (64.2%); de-escalation of therapy after a few days (63.9%); sequential intravenous/oral therapy for antibiotics with equivalent bioavailability (78.7%); dedicated antimicrobial order forms (36.1%); automatic stop of delivery (43.5%); analysis of antibiotic consumption data (96.2%); and analysis of microbial resistance data (89.8%). Conclusions: These data demonstrate a well-developed structure of AMTs in Belgian hospitals and the broad range of services provided. Technical and financial support by healthcare authorities was key to the extensive implementation of antimicrobial stewardship programmes across the national hospital care system. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.
Steensels D.,University Ziekenhuizen Leuven Gasthuisberg |
Slabbaert K.,University Ziekenhuizen Leuven Gasthuisberg |
De Wever L.,University Ziekenhuizen Leuven Gasthuisberg |
Vermeersch P.,University Ziekenhuizen Leuven Gasthuisberg |
And 2 more authors.
Clinical Microbiology and Infection | Year: 2012
Although the estimate of the incidence of sepsis following transrectal ultrasound-guided prostate biopsy (TRUSPB) is low, fluoroquinolone-resistant infections after prostate biopsy are being increasingly noted. This study was aimed at determining the prevalence of faecal carriage of fluoroquinolone-resistant Escherichia coli strains before TRUSPB and at evaluating potential predisposing risk factors. The incidence of sepsis after prostate biopsy was determined, and our routine practice for antibiotic prophylaxis for TRUSPB was evaluated. A prospective study was conducted in 342 consecutive patients undergoing prostate biopsy between December 2009 and July 2010. Before TRUSPB, a rectal swab was cultured. The correlation between the presence of fluoroquinolone-resistant strains and plausible risk factors was investigated by the use of a questionnaire. Of the 236 patients included, 22.0% (52/236) harboured ciprofloxacin-resistant E. coli strains. The use of fluoroquinolones in the 6 months before biopsy was associated with an increased risk of faecal carriage of fluoroquinolone-resistant E. coli strains (p<0.01). Faecal carriage of fluoroquinolone-resistant E. coli strains was an important risk factor for infectious complications after TRUSPB (p<0.01). In conclusion, a significant number of patients have faecal carriage of fluoroquinolone-resistant E. coli strains (22.0%) before TRUSPB. The use of fluoroquinolones in the previous 6 months before biopsy is a risk factor for faecal carriage of fluoroquinolone-resistant E. coli strains and for infectious complications after TRUSPB. Hence, the universal administration of fluoroquinolones should be reconsidered. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.