Improving Antibiotic Use in the Community The Belgian Experience Samuel Coenen Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Belgian antibiotic campaign Different kinds of interventions (2000-2005) Public campaigns (BAPCOC) (cid:153) Information for prescribers in ambulatory care: (cid:153) Guidelines (Scientific Colleges and BAPCOC) • Prescribing information (Folia Pharmacotherapeutica (BCFI)) • Conclusions of consensus meetings (NHDII) • Prescribing feedback (NHDII, Scientific Colleges, IMA, …) • Medflash (BAPCOC) • Other projects (FWO, FGOV, EC, …) (cid:153) Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Belgian antibiotic campaign Guidelines (Scientific Colleges and BAPCOC) Acute sore throat (2001) • Acute otitis media (2001) • Acute cystitis in women (2001) • Vaginitis and vaginose (2001) • Acne (2002) • Acute cough (2002) • Chlamydia trachomatis (2004) • Acute rhino-sinusitis (2004) • Acute exacerbation of COPD • Acute lower respiratory tract infection • www.wvvh.be – www.ssmg.be - www.bapcoc.be Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Belgian antibiotic campaign Prescribing information (Folia Pharmacotherapeutica (BCFI)) Antibiotic resistance, a challenge for physician and pharmacists (2000) • Rational use of antibiotics in acute respiratory tract infection in primary • care (2004) Rational use of antibiotics in urinary tract infection in primary care (2005) • Conclusions of consensus meetings (NHDII) Appropriate use of antibiotics in acute infections of ear-nose-throat and • the lower respiratory tract in ambulatory care (2000) Appropriate use of antibiotics in acute enteritis and acute uro-genital • infections in ambulatory care (2001) Medflash (BAPCOC) www.bcfi.be – inami.fgov.be - www.bapcoc.be Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Belgian antibiotic campaign Medflash (BAPCOC) www.bapcoc.be Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Belgian antibiotic campaign Other projects European Conference on Antibiotic Use in Europe (2001)* • European Surveillance of Antimicrobial Consumption (ESAC) (2001-) • Antibiotics for coughing in general practice (2003) • Antibiotic for acute cystitis in general practice (2004) • Antibiotics for acute rhino-sinusitis in general practice (2005)* • International Workshop on Educational Campaigns (2004) • ESAC Ambulatory Care Subproject (2005-) • ESF Workshop on Antibiotic Prescribing Quality Indicators (2005) • Genomics to combat Resistance against Antibiotic in Community- • acquired lrti in Europe (GRACE) (2006-) * Project Farmaka www.antwerpgp/be - www.ua.ac.be/esac – www.esf.org Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Public educational campaigns in Belgium I-III: Antibiotics: use them less often but better (2000-2003) IV : For flu, common cold and acute bronchitis antibiotics won’t help (2004) Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Public educational campaigns in Belgium I - III Antibiotics: use them less often but better www.red-antibiotica.org – JAMA 2005;292;2468-70 Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Two Public Campaigns for a (2000-2001 and 2001-2002) More Rational Use of Antibiotics in Belgium: Succes and Limitations I. BAURAIND +, E. HENDRICKX, I. VANDEN BREMT, H. GOOSSENS, Ph. MOUCHET, P. TREFOIS, F. YANE, J.-L. MARCHAL, B. SEYS, J.M. LOPEZ- LOZANO, A. BEYAERT, P.M. TULKENS & L. VERBIST • Federal Public Services of Social Affairs, Public Health & Environment, Brussels; • Universiteit Antwerpen, Antwerp; • Question Santé asbl, Brussels; • Belgian Institute of Pharmacoepidemiology, Brussels; • Belgian Institute of Public Health, Brussels; • Hospital Vega Baja, Orihuela-Alicante, Spain; • Universidad de Murcia, Murcia, Spain; • Université catholique de Louvain, Brussels; • Katholieke Universiteit Leuven, Louvain; _______ + deceased Feb 2002 Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders Why the campaigns (as seen in 1999) ? 40 ) y a d 30 • Belgium (10 mill. / . h n i inhab.) has a larger AB 20 0 Belgium EU-range 0 0 , consumption than most 1 / 10 D D D EU countries ( s 0 e (various convergent sources) l a S c i t o 30 i b i t n A t 25 n • this consumption has e i t a p remained constantly t u 20 O high over the 1996 - 1996 1997 1998 1999 Year 1999 period Centre for General Practice - University of Antwerp & Fund for Scientific Research - Flanders (d t f th B l i I tit t f