Acta Clinica Belgica

Schmitz, L.; Yepiskoposyan, L.; Bouteille, A.; Wybo, I.; Allard, S. D.; Pauwels, S.; Hubloue, I.; Van Honacker, E.; Van Laethem, J.

2025 Acta Clinica Belgica

doi: 10.1080/17843286.2024.2446684pmid: 39750032

Objectives Urinary tract infections (UTIs) are an important cause of empiric antibiotic (over)treatment at the emergency department (ED). To enhance empiric antibiotic choices, mapping the national and local microbiology and antimicrobial resistance (AMR) patterns is crucial. This study aims to examine resistance patterns at a Brussels ED and to identify risk factors for AMR to evaluate current treatment guidelines and help combat AMR. Methods Adult patients undergoing urinalysis at the ED of a Brussels tertiary care hospital with positive urine cultures were included. Descriptive microbiological mapping of UTI or asymptomatic bacteriuria (ASB) micro-organisms was performed. Potential risk factors of antibiotic resistance in Gram-negative bacteria were assessed by using logistic regression analysis. Results Out of 96 patients with Gram-negative bacteria in urinary culture, the predominant uropathogen was Escherichia coli (58.3%), with 8.6% being extended spectrum beta-lactamase (ESBL)-producing strains. Overall, fosfomycin (29.2%) and nitrofurantoin (28.6%) showed the highest resistance rates. Ceftriaxone revealed lower resistance rates (13.1%) compared to ciprofloxacin (17.0%) and cefuroxime (18.4%). Temocillin exhibited the lowest resistance rate (8.2%) especially against ESBLs (0%). Ciprofloxacin resistance increased with age (OR 1.05 [1.01–1.10]) and recurrent UTIs (OR 4.79 [1.18–19.42]). Male gender was associated with higher odds of temocillin resistance (OR 5.79 [1.18–28.34]). Conclusion In the studied Belgian ED setting, ceftriaxone seems slightly safer than ciprofloxacin, especially for recurrent UTI patients. However, overall, and especially in patients at risk for ESBL-producing bacteria, temocillin would be an even better choice in our setting. National microbiological data should be reviewed to support recommending temocillin as a first-line antibiotic in patients presenting with upper UTI.

Lins, R.; Waterbley, P.; Shivalkar, B.; de Hoon, J.; Rottey, S.; Present, E.

2025 Acta Clinica Belgica

doi: 10.1080/17843286.2024.2446681

Belgium has a vibrant health eco-system, with world-class universities and hospitals, and a strong presence of pharmaceutical companies, resulting in a substantial contribution to drug development and a high number of clinical trials. Talent development is pivotal for further growth of this eco-system and to attract future professionals. Although physicians play an important role in this complex eco-system, with an estimated 400–450 Belgian physicians presently active in the field of the drug life cycle, Pharmaceutical Medicine and Clinical Pharmacology were not recognized as a speciality in Belgium until recently. It took a group of engaged people almost 20 years to create this new title, based on the European Directive 2005/36/EG appendix V, mentioning the medical specialties accepted in Europe and requiring a minimum training of 4 years. Although in this directive only ‘pharmacology’ is mentioned, a title of physician-specialist in Clinical Pharmacology/Pharmaceutical Medicine was proposed by the High Council for Physician-Specialists and General Practitioners to the Minister of Social Affairs. The Ministerial Decree was finally published in October 2023. The current paper describes the process of unwavering perseverance, clarity on the added value offered to stakeholders and the continued support of advocates in reaching the goal.

Kaes, Anneleen; Buyle, Franky; Quintens, Charlotte; Van Eijgen, Astrid; Zubryckyj, Larissa; Boussery, Koen; Vanoverschelde, Anna

2025 Acta Clinica Belgica

doi: 10.1080/17843286.2024.2448357pmid: 39799001

Objectives Implementation of outpatient parenteral antimicrobial therapy (OPAT), also known as intravenous (IV) antimicrobial treatment at home, has increased in recent years. Ensuring OPAT quality is crucial to achieve positive patient outcomes. However, data on the Belgian quality of OPAT organisation is lacking. We aimed to monitor the organisational quality of OPAT in Belgian hospitals and identify roles of hospital pharmacists involved in OPAT. Methods A cross-sectional study applying a web-based survey on OPAT quality was conducted from 2 to 29 April 2024. The survey assessed the presence of six core and five non-core structure indicators, and OPAT-related tasks of hospital pharmacists. Results Almost two-thirds (64%; 65/101) of Belgian hospitals answered the survey, with 77% of these hospitals providing OPAT, with an increase since 2023. All 11 structure indicators were present in 6% of hospitals, while 18% had all six core structure indicators. Three of the six core structure indicators were formally present in the majority of the hospitals: a policy on patient selection criteria (76%), a structured OPAT programme (70%), and a dedicated team (64%). In contrast, a system for fast communication between the patient and OPAT team members (50%), a mechanism for urgent clinical discussions (42%), and monitoring of quality indicators (28%) were not formally present in the majority of the hospitals. The primary tasks for hospital pharmacists included overseeing OPAT prescriptions and supplying antimicrobials and related materials. Conclusion While the adoption of OPAT is increasing among Belgian hospitals, significant opportunities remain for improving the quality of the OPAT organisation and expanding the OPAT-related tasks of Belgian hospital pharmacists.