By the end of the 90s, Belgium was in the top 3 of European countries having the highest antibiotics consumption. This overconsumption constitutes a threat to public health.
Nine years later, in 1999, Belgium reacts by establishing the Belgian Antibiotic Policy Coordination Committee (BAPCOC). This is a federal instance that is highly scientifically based aiming to promote rational antibiotics consumption and to fight the increase of antibiotics resistance.
The Commission is composed of several working groups (to TAB working groups) among which:
The activity of BAPCOC and its working groups is explained under the section « organization chart ».
In practice, the different working groups of BAPCOC have the following missions:
Check Our Policy paper for more details about the objectives for the 2014-2019 term.
The multidisciplinary commission is composed of scientists, (general) practitioners, microbiologists, hospital hygienists, pharmacists, veterinarians, and political decision makers. The commission can appeal to the Scientific Public Health Institute for scientific support.
Organizational chart BAPCOC
Role within BAPCOC
Ch. PF Hospital hygiene
VCh. PF Hospital hygiene
Ch. Hospital medicine
VCh. Hospital medicine
Ch. Veterinary medicine
VCh. Veterinary medicine
An De Sutter
Ch. Ambulatory medicine
VCh. Ambulatory medicine
FPS Public Health
Anali Conesa Botella
Ch.: Chairman; VCh.: Vice chairman
Policy paper for the 2014-2019 term
The Commission is composed of different working groups, among which:
- Ambulatory practice,
- Veterinary medicine,
- Hospital medicine,
- Federal hospital hygiene platform.
Mission and composition
The specific objectives of the working group Ambulatory practice are:
This approach can’t be independent from the approach applied to human medicine, which means that close cooperation with the other BAPCOC working groups is crucial (the so-called "One Health" principle).
Mission and composition
In collaboration with BAPCOC’s working group Ambulatory Practice, thanks to a better knowledge of proper antibiotics use and better consultation and communication skills, combined with an improved behavior in the field of antibiotics prescription, we aim at a decrease of the total yearly antibiotics consumption from more than 800 prescriptions per 1000 inhabitants today, to 600 prescriptions by 2020 and 400 prescriptions by 2025.
The results are the fruit of cooperation between BAPCOC and several authorities, with the input of scientific societies of physicians and pharmacists and the expertise in social marketing.
Our interventions and campaigns address practitioners (e.g. GRACE INTRO) but also the public (e.g. Bob et Bobette, e-bug ).
The main objective of the strategic plan 2014-2019 is to consolidate the action of the antibiotherapy management groups of « antibiothérapie » (gestion de l'antibiothérapie (GGA)) and to improve the quality of antibiotics use by means of indicators. These groups are asked to perform internal audits analyzing a series of medical files of patients after surgery. These analyses allow to measure to which degree the choice of the antibiotic and the duration of the antibiotic prophylaxis meet the local instructions.The objective pursued is to reach a plus-90% procedure conformity in all Belgian hospitals by 2019, by means of improvement actions.Since 2002, the pilot project has been implemented in all acute and chronic hospitals counting at least 150 beds of the 'Sp' or 'G' type.
A point allows to check the antibiotics consumption of all the hospital’s patients for a given day. In case antibiotics were prescribed the reason has to be mentioned in the medical file and the antibiotic must have been chosen in accordance with the local instructions. Too often, the indication for using antibiotics is not mentioned in the medical file. By 2019 we want more than 90 % of the antibiotics prescriptions to be in accordance with the local directives.
Currently the main objectives of this federal platform are to:
The federal platform elaborates propositions to the health authorities, guides the activities of the regional platforms, fosters their strategies and contributes to provide them with ad hoc methodological tools.
See also the publications of NOSO.INFO.
Hyperlinks to related themes on the FPS’s webpages
Hyperlinks to related themes, outside the FPS’s portal site:
Become an Antibiotic Guardian and choose your pledge now!
Read the opinion of Prof. Goossens, President of BAPCOC: "Shout about the European Union’s success".
The editions dating back to 2006 or earlier are still available on the UCL's website. The numbers from 2007 up to 2014 can be downloaded.
Since 2014, NOSO Info is only available electronically. Four editions are still published every year.
Coenen S, Costers M, De Corte S, De Sutter A, Goossens H. The first European Antibiotic Awareness Day after a decade of improving outpatient antibiotic use in Belgium. Acta Clin Belg 2008; 63: 296-300.
Coenen S, Costers M, De Corte S, De Sutter A, Goossens H. Feed Back sur les « campagnes antibiotiques » belges. La Revue de la Médecine Générale 2008;(257):286-9.
Goossens H, Coenen S, Costers M, De Corte S, De Sutter A, Gordts B, Laurier L, Struelens M. The Belgian Antibiotic Policy Coordination Committee (BAPCOC). Eurosurveillance 2008; 13 (46): 10-13.
De Sutter A, Coenen S. La journée européenne sur le thème des antibiotiques du 18 novembre 2008. Folia Pharmacotherapeutica 2008; 35: 96.
Information for health care providers
In 2016-2017 BAPCOC actively prepared an online training module that will be accessible for all general practitioners in Belgium. The module BAPCOC GRACE INTRO already showed that we can significantly and safely reduce antibiotics prescriptions by general practitioners in Belgium, Britain, the Netherlands, Poland, Spain and Wales on the short and on the long run. The module has furthermore been appreciated by physicians and patients. It includes a general introduction on coughing, antibiotics, resistance etc, but above all a communication training for general practitioners featuring concrete examples (on video) about how they can successfully conduct a consultation with a patient suffering from a (non-severe) bronchi infection and how they can interactively use a personalized brochure containing relevant information for patients. More info will be available soon.
Global Point Prevalence Survey Antimicrobial Consumption and Resistance
In 2015 BAPCOC coordinated this global project in collaboration with the Antwerp University (UA, software type application): www.global-pps.com. The first results were presented on the occasion of the European Antibiotic Awareness Day on November 18th, 2015
On the European level, ECDC organizes a point prevalence survey (PPS) every 5 years on hospital related infections and use of antibiotics in acute hospitals. The last survey was in 2011. The Scientific Public Health Institute (ISP) organized this PPS for Belgium.
Report including the results for Belgium (year 2011).
This survey will be repeated in 2016-2017. More information will soon be available on the ISP website (www.wiv-isp.be).
Report including the results for Belgium (year 2011).
Documents on the PPS 2015.
FAQ’s and IT manual are available on the website www.global-PPS.com
See the members'list
Generic email account :
Antibiotherapy management groups (GGA)
Campaign since 2014
Bob et Bobette: Tante biotica
information sur e-bug
Publication of the final report featuring the results of the Campaing "You are in good hands" 2008-2009 .
For the sensitizing actions’ posters, please consult the page « Brochures ».
Coordinated by BAPCOC, a working group consisting of infectiologists, general practitioners and epidemiologists has developed a scientific literature based recommendation on the prevention, the diagnosis and the treatment of Lyme borreliosis. This recommandation was validated by the Belgian Infectiology and Clinical Microbiology Society (SBIMC), Domus Medica, the Royal Belgian Society for Rheumatology (SRBR), the Flemisch Neurology association (VVN, Vlaamse Vereniging voor Neurologie) and the Public Health institute.
BAPCOC published its first newsletter edition.
Following the recent increase of Carbapenemase-producing Enterobacteriaceae (CPE), the Federal Public Health Service has taken a certain number of measures.
Guide belge des traitements anti-infectieux en pratique ambulatoire - édition 2012
Intercalaire antibiotiques pour médecins généraliste - édition 2012
'antibiotics charts' for pharmacists
Besides the name of the antibiotic medicine, more and more physicians mention the duration of the antibiotherapy on their prescription sheets. Indeed, the new recommendations for taking antibiotics advise a certain number of days for antibiotherapy. However the duration of the treatment does not always correspond to the number of tablets available in the package, and leftovers are accumulated in the patient’s home. Stocking antibiotics leftovers in domestic medicine chests has to be avoided as it incites to self-medication. Moreover the boxes of antibiotics that were started no longer contain sufficient tablets for an efficient therapy. These leftovers of antibiotics are not only useless, they also constitute a risk of developing resistance.
Since 2011 all Belgian pharmacists are asked to apply a sticker to all boxes of antibiotics they sell during the national ‘antibiotics’ campaign. This action also allows to open a dialogue with the patient about the proper use of antibiotics.
Treatment of acute gastroenteritis in ambulatory practice
Treatment of acute COBP-exacerbations in ambulatory practice
Treatment of acute exacerbations - detailed chart for physicians
Recommendations of the High Health Coucil on hand hygiene
The WHO guidelines on Hand hygiene
Belgian guide of anti-infectious treatments in ambulatory practice - 2008 edition
Guidelines acute Cystitis in women
Guidelines acute throatache
Guidelines acute Otitis
Guidelines acute Rhinosinusitis
Guidelines acute infections of the lower bronchi in adult patients
Belgian guide of infectious treatments in ambulatory practice - 2006 edition
Guidelines acute Pyelonephritis frite in adult patients 2003
Guidelines bacterial meningitis 2005
Strategic Antibiotics Plan 2003
Reports Technical Cell 2005
Circulaire: Normes d´agrément en matière d´hygiène hospitalière
Circulaire: Normes afférentes au groupe de gestion de l´antibiothérapie
On Wednesday Nov. 18th 2015, on the occasion of the European Antibiotic Awareness Day, BAPCOC organized a meeting day ONE HEALTH STRATEGY. This meeting allowed each of the working groups to present their activities and results.
Programme and presentation
Final ECDC report , including the results for Belgium (year 2011).