ABS INTERNATIONAL - Implementing antibiotic strategies (ABS) for appropriate use of antibiotics in hospitals in member states of the European Union

EC contribution: : € 798.598
Duration: : 24 months
Starting date: : 01/09/2006
Funding scheme: : N/A
Keywords: : antibiotics (AB), anti-infectives, antibiotic stewardship, antibiotic strategies, antibiotic prophylaxis, antibiotic therapy, antibiotic culture, antibiotic use
Contract/Grant agreement number: : 2005208
Project web-site: :http://www.abs-international.eu/

Background:

The aim of the project is the further development of organizational competencies regarding the adequate antibiotic use in the cooperating hospitals of the partner countries, as well the qualification of doctors and pharmacists in the adequate antibiotic use. Furthermore quality indicators and process measures for antibiotic use

The project will be implemented in 9 Member States of the EU with a fair balance of old and new Member States: Austria, Germany, Belgium, Italy, Poland, Hungary, Czech Republic, Slovenia and Slovakia.

The project will last for 2 years (September 2006 - September 2008). The project can be broken down into 8 work packages.

Workpackage 1.1 "Project Management", Workpackage 1.2 "Dissemination of Results" und Workpackage 1.3 "Evaluation of the Project" are workpackages predetermined by te EU and comprehend project start, project co-ordination, project controlling and project close-down, as well as the financial and administrative management between the EC and the partner countries.

Workpackage 4 "Planning and Preparation" includes the development of templates for ABS Tools (AB list, Guide for AB treatment, Guide for surgical prophylaxis, AB consumption controlling) and the development of standard AB-related organizational structures (AB-related communication structures for a hospital, role descriptions for AB-officers and for AB-contact persons in hospitals, etc.).

Within workpackage 5 "Process measures and QI for AB Use" process measures and quality indicators will be developed and subsequently validated in cooperation hospitals.

The indicators include four antibioprophylaxis quality indicators, seven antibiotherapy indicators regarding Staph. aureus bacteremia (SAB), community acquired pneumonia (CAP) and appropriate IV-PO switch, as well as more than 20 structural indicators.

At the beginning of workpackage 6 "Preparation per partner country" the ABS maturity of each partner country will be analysed with a questionnaire on the antibiotics culture in hospitals. Upon the results country reports will be published. The cooperating hospitals and members of the ABS trainer teams in each country will be established.

The performance of the "Train the ABS Trainer/ABS Consultant" programme and the subsequent ABS trainings for the hospital teams is part of workpackage 7 "Implementation per Partner Country". Additionally, the ABS tools will be adapted and implemented in the cooperating hospitals of the partner countries.

Within the last workpackage 8 "Preparation of the Post-Project Phase" an EU-wide final conference will take place. Also an EU-wide ABS expert network shall be established.

The 10 associated partners of the ABS INTERNATIONAL are: ULB Free University of Brussels (BE), University Hospital of Freiburg (DE), National Institute of Public Health (PL), University of Pecs (H), Na Homolce Hospital (CZ), University Medical Centre Ljubljana (SI), University of Verona (IT), St. Elizabeth Hospital (SL), ABS GROUP (AT) and Johannes Kepler University (AT).

Problem:

In human medicine, the use of anti-bacterial agents for the treatment of viral infections, the unjustified use of substances with an extremely broad activity spectrum, and the "prophylactic" use of antibiotics over too long periods prior to surgical interventions, as well as the use of antibiotics in cases of mere colonization (and not infection) of the patient are regarded as the main causes of the resistance problem.

In addition, patients (in the case of children, their parents) contribute to the misuse of antibiotics on account of their inappropriate demands regarding therapy. The causal relationship between the use of antibiotics and the emergence of resistance in bacteria is documented for infections in patients as well as for nosocomial (i.e. hospital-borne) infections.

The Recommendation of the Council of 15 November 2001 on the prudent use of antimicrobial agents in human medicine calls upon Member States to make sure that specific strategies for the prudent use of antimicrobial agents are in place and are being implemented, with the goal of limiting the increase in the number of pathogens that are resistant to these agents.

In hospitals, and particularly in intensive care units, multi-resistant hospital germs are a constant problem. The potential transfer of resistant genes from potentially pathogenic bacteria to super-virulent infectious bacteria (e.g. from Vancomycin-resistant Enterococcus faecium to a Staphylococcus aureus strain) poses a serious threat. This incident, which had been feared for a long time, was in fact described for the first time in the USA in 2002.

Many individual efforts exist to scope with microbial agents but often no coherent strategies are in place, organisational structures are missing, and the awareness of the prudent use of AM agents is low.

Aim:

The general objectives of the project were:

to develop the organisational tools and qualified capacities for identifying and distributing best practice on the prudent use of antimicrobial agents in human medicine in hospitals,;
to enhance and implement specific strategies for the prudent use of antimicrobial agents in hospitals,;
to elaborate methods for evaluating the applied antimicrobial strategies;,
to disseminate the project results across the European Union and Candidate Countries.

The specific objectives of the project are:

Prepare a training programme for national ABS trainers ("Train the Trainer"),
Develop standard organisational tools for hospitals to assure appropriate antibiotic use,
Develop standard organisational templates for prophylaxis and therapy (ABS tools),
Develop and validate process measures and quality indicators for the antibiotic use as evaluation instruments,
Analyse the ABS culture per partner country,
Implement a training programme for ABS experts per partner country,
Develop organisational structures per cooperating hospital,
Develop recommendations for prophylaxis and therapy per cooperating hospital,
Publish "Guidelines to Further Develop and Define Antibiotic Use in Hospitals" per country,
Establish an international network of ABS experts, plus national networks in each partner country.

Expected and obtained results :

The main deliverables of the project are:

Standards for ABS Tools (AB List, Guide for AB treatment, Guide for surgical propylaxis, AB consumption controlling, AB-related organization)
Training Programme "Train the ABS Trainer/ABS Consultant"
ABS Training and ABS Consulting for cooperating hospitals in each partner country
Process measures and quality indicators developed and tested; results summarized in a validation report
Country reports on the results of the ABS maturity survey per partner country
"Guidelines to Further Develop and Define Antibiotic Use in Hospitals" per country
ABS Expert network.
Final ABS conference

Potential applications:

The project relates primarily to Article 3.2.a., Annex - point 2.9. of the Public Health Programme and point 2.2.5. Antimicrobial resistance of the Work Plan 2005. In the Work Plan 2005 it is stated that "priority will be given to activities which will support the "Strategy against antimicrobial resistance" as laid down in a Communication of the Commission of July 2001. Priority will be given to identifying and distributing best practice on the prudent use of antimicrobial agents and infection control measures in human medicine in hospitals and the community …"

This project ABS INTERNATIONAL is further develops the strategy for the prudent use of antimicrobial agents in hospitals and the distribution of best practice including training among 9 countries of the European Union, 4 of which are new Member States.

Coordinator:

Prof. Dr Roland Gareis and Mag. Annegret Frank
Roland Gareis Consulting
Silbergasse 30
1190 Vienna, Austria
Tel. +43 13677022-0
Fax +43 13677022-70
Roland.gareis@rgc.at

European Commission