In short
Overuse or misuse of antimicrobials lead to pathogens becoming resistant to them (the so-called antimicrobial resistance (AMR)), making infections harder to treat. In hospitals, antimicrobial stewardship (AMS) programs are crucial in combating this threat because they ensure that antibiotics and other antimicrobial agents are used judiciously and effectively. Since 2007, the Belgian Antibiotic Policy Coordination Committee (BAPCOC) has been supporting Belgian hospitals in establishing Antibiotic Management Teams (AMT) with federal funding and legal framework to develop AMS programs. This short-term project (1.5 years) aligns with Belgium’s broader plan to combat AMR, known as the “One Health” national action plan. Its aim is to describe the current landscape of AMS programs in place in Belgian hospitals and assess the barriers and facilitators of such programs in order to make recommendations to optimise their effectiveness. It benefits from funding from the Federal Public Service Public Health, Safety of the Food Chain and Environment and is led by Sciensano, with the support of Belgian and international experts in antimicrobial stewardship.
Project description
To optimise the use of antimicrobials in hospitals, the Belgian Antibiotic Policy Coordination Commission (BAPCOC) has been supporting, since 2002, the implementation of Antimicrobial Stewardship (AMS) programs through the establishment of Antibiotic Management Teams (AMT) in 36 hospitals. These initiatives have received federal funding and political guidance as outlined in the Royal Decree (RD) of April 25, 2002. Subsequently, in July 2007, AMS programs were expanded nationally with the introduction of a legal framework and funding (RD of February 12, 2008, which amended the RD of March 4, 1991, establishing the standards for hospital dispensaries to gain approval). According to these RDs, multidisciplinary AMT became mandatory in all hospital structures with 150 beds or more, with the minimum composition and tasks of these teams being explicitly defined.
However, recent reports from the Federal Centre of Expertise for Healthcare (KCE) and the European Centre for Disease Prevention and Control (ECDC) have identified significant areas for improvement. These reports identified several issues, including the involvement of multiple national entities in the fight against antimicrobial resistance (e.g. National Institute for Health and Disability Insurance (INAMI), Federal Agency for Medicines and Health Products (FAMHP), Federal Public Service (SPF), Sciensano, etc.) leading to fragmented actions and organisational gaps. The visibility of BAPCOC was found to be limited, and inadequate support was provided to AMTs. Furthermore, AMTs lacked defined objectives and tools, faced resource constraints in terms of time and staff, had limited engagement from medical managers, lacked data on the utilization of annual federal funding, faced no consequences for under-performance, and lacked recognition of infectiology and medical microbiology.
To address these issues, the BEAST project (lasting 1.5 years) was launched to optimise the functioning of the Belgian AMTs. This project aligns with Belgium’s “One Health” national action plan to combat AMR 2020-2024 (NAP-AMR), financed by FPS Public Health, Safety of the Food Chain and Environment and led by Sciensano, with the support of Belgian and international experts in the field of antimicrobial stewardship.
The project aims to achieve two main objectives:
- Describe and evaluate the functioning of AMTs at both national and local levels.
- Formulate recommendations to adapt legislation and optimise the functioning of AMTs, with a focus on disseminating the results.
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