Inappropriate use of antimicrobial drugs is a major driver of antimicrobial resistance. Monitoring antimicrobial consumption is therefore one of the action points in the fight against antimicrobial resistance. Sciensano organizes the BeH-SAC project, the surveillance of antimicrobial consumption in Belgian hospitals. This project is based on reimbursement data of the National Institute for Health and Disability Insurance (NIHDI). It allows Belgian hospitals to monitor the consumption of antimicrobial drugs over time and to compare this consumption with similar hospitals or specific departments.
In June 2017, the importance of the surveillance of antimicrobial use was underlined in the new ‘One Health Action Plan against Antimicrobial Resistance’ of the European Commission.
Since 2007, a detailed surveillance of antimicrobial consumption has been implemented in Belgian acute care and large chronic care hospitals (≥150 beds), with the possibility to benchmark this consumption with other hospitals. At that time, hospitals were sending themselves their antimicrobial consumption data to the Belgian Institute of Public Health.
In 2018, Sciensano launched the BeH-SAC project based on the use of reimbursement data from the National Institute for Health and Disability Insurance (NIHDI). The main advantage of BeH-SAC in comparison with the old methodology is the decreased variation in data collection across hospitals.
The objectives of BeH-SAC are:
- To develop and offer a scientifically standardized methodology to Belgian hospitals, to follow-up their antimicrobial consumption in a quantitative way through time.
- To give Belgian hospitals the opportunity to benchmark, based on their antimicrobial consumption, with similar hospitals.
- To provide national and regional data (with an reasonable delay in time) to be able to evaluate the antimicrobial consumption in Belgian hospitals.
The antimicrobial agents are defined based on the Anatomical Therapeutic Chemical (ATC) classification of the World Health Organisation (WHO): A07A, D01BA, J01, J02, J04A, J05, P01AB. The consumption is expressed in defined daily doses (DDDs) per 1000 patient days and DDDs per 1000 admissions. For more information, do not hesitate to consult the latest version of the BeH-SAC protocol and download here the latest version of the DDD list : ddds_list_2023.xlsx
Results are available per year/trimester and per hospital/hospital unit. National reports and feedback reports per hospital are provided on an interactive platform Healthstat.be, with benchmarking and stratification at different levels (type, size, region). The results of BeH-SAC can help hospitals to set targets for improvement concerning antimicrobial consumption and to evaluate the implementation of antimicrobial stewardship programmes.
No action is required from hospitals to participate in this national surveillance. Sciensano collects the surveillance data on antimicrobial consumption automatically via the reimbursement data from the NIHDI.
The national data on antimicrobial consumption in Belgian hospitals (acute/categorical/psychiatric hospitals) are publically available on the website of Healthstat and published in descriptive reports (see the section ‘Associated publications’).
Every hospital can consult their individual results of antimicrobial consumption on the website of Healthstat.
How can you get access to these new hospital reports?
In case your hospital already participated in the BeH-SAC surveillance in the past:
- Contact the RAE (Responsible Access Entity) of your hospital. This person can request an E-Health account for you and can subsequently activate the access to the BeH-SAC reports. The following link (Dutch/French) contains step by step instructions for the RAE to arrange the access.
- Afterwards, you can login on Healthstat with your electronic identity card to open the reports. A user manual to getting started on Healthstat can be consulted via this link.
- In case of technical problems, please contact Healthdata using their ticketing tool or by phone +32 (0)2 793 01 42.
- If you have questions concerning the reports, you can contact the project leader Lucy Catteau (Lucy.Catteau@sciensano.be or +32 (0)2 642 50 26).
If this is the first time that your hospital participates in the BeH-SAC surveillance:
Please contact the project leader Lucy Catteau for further instructions (Lucy.Catteau@sciensano.be or +32 (0)2 642 57 68).