Sourdeau L, Struelens M J, Peetermans W E, Costers M, Suetens C
Institut Scientifique de Santé Publique, Rue J Wystman 14 1050 Bruxelles.
Acta Clin Belg. 2006 Mar-Apr;61(2):58-63. doi: 10.1179/acb.2006.011.
In 2002-03, the Belgian government subsidized in part the activities of local Antibiotic Managers (AMs) in 36 hospitals selected based on the presence of an operational multidisciplinary Antibiotic Management Team (AMT). AMs were trained as Internists (28), Microbiologists (13) and Hospital Pharmacists (13). The hospitals were representative of Belgian hospitals in affiliation, regional origin and size. The financing scheme allowed the implementation of 175 antibiotic management interventions, with a mean of 5 interventions/hospital. The activities reported in the first 9-month progress reports were analyzed according to national guidelines for AMTs. 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 selected antibiotics (25), improvement of antibiotic susceptibility testing methods (12), development of antibiotic consumption database (35) and analysis of antibacterial susceptibility data (31). Advertisement type categorization of communication methods showed that education of prescribers was based on multimodal communication. All hospitals used at least one passive method, 39% at least one active method and 55% at least one personalized method. The quality of communication was higher in hospitals with teaching affiliation. In conclusion, hospitals that received a financial incentive under theAMT pilot phase have developed multimodal antibiotic policy interventions independently of the hospital size and teaching status. Extension to all Belgian hospitals appears warranted. The impact of AMTs and AMs on the quality of use of antibiotics and trends of antibiotic resistance and cost will be monitored based on standardized indicators.
在2002 - 2003年期间，比利时政府对比利时36家医院中当地抗生素管理人员（AM）的活动给予了部分补贴，这些医院是根据是否存在运作良好的多学科抗生素管理团队（AMT）挑选出来的。抗生素管理人员分别接受了内科医生（28名）、微生物学家（13名）和医院药剂师（13名）的培训。这些医院在所属关系、地区来源和规模方面代表了比利时的医院。该资助计划允许实施175项抗生素管理干预措施，平均每家医院5项干预措施。根据针对抗生素管理团队的国家指南，对前9个月进度报告中所汇报的活动进行了分析。所有医院，无论规模大小或所属关系如何，都采取了广泛的措施：审查处方集（29家）、实施新的临床指南（24家）、限制获取某些选定的抗生素（25家）、改进抗生素敏感性检测方法（12家）、建立抗生素消费数据库（35家）以及分析抗菌药敏数据（31家）。对沟通方式的广告类型分类显示，针对开处方者的教育是基于多模式沟通的。所有医院至少使用了一种被动方法，39%的医院至少使用了一种主动方法，55%的医院至少使用了一种个性化方法。具有教学附属关系的医院沟通质量更高。总之，在抗生素管理团队试点阶段获得财政激励的医院，无论医院规模和教学状况如何，都独立开展了多模式抗生素政策干预措施。似乎有必要将其推广到所有比利时医院。将基于标准化指标监测抗生素管理团队和抗生素管理人员对抗生素使用质量、抗生素耐药性趋势及成本的影响。
