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Die Situation in den Niederlanden (The Dutch Approach)

Die Situation in den Niederlanden (The Dutch Approach). Hajo Grundmann University Medical Centre Groningen, Rijksuniversiteit Groningen, National Institute for Public Health and the Environment, Bilthoven, NL. The Dutch approach. robust targeted effective. The Dutch approach. robust

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Die Situation in den Niederlanden (The Dutch Approach)

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  1. Die Situation in den Niederlanden(The Dutch Approach) Hajo Grundmann University Medical Centre Groningen, Rijksuniversiteit Groningen, National Institute for Public Health and the Environment, Bilthoven, NL

  2. The Dutch approach • robust • targeted • effective

  3. The Dutch approach • robust • targeted • effective

  4. The Dutch approach Following an outbreak of Oxa-48 +ve Klebsiella pneumoniae that infected 58 patients in an acute care hospital in Rotterdam between Sept. 2010 and June 2011 (attributable mortality 5-22%), 4.000 patients were called back for screening (approx. 2.000 have been screened so far and 20 carriers have been identified)….

  5. The Dutch approach ….the hospital laboratory (microbiology) and infection control department were put under external supervision, and the hospital director was fired (August 16).

  6. Antibiotic policy (Nat. Health Council 2001) Working Group on Antibiotic Policy, SWAB (Stichting Werkgroep Antibiotica Beleid). • training programmes for the rational prescription of antimicrobial drugs, • development of evidence-based prescription guidelines, • the implementation of tailor-made hospital guidelines for antibiotic prophylaxis and therapy, • integrated nationwide surveillance system for antibiotic use and antimicrobial resistance.

  7. Antimicrobials for systemic use (J01)

  8. Germany Netherlands Antimicrobials for systemic use (J01)

  9. The Dutch approach: a sceptical view • The Dutch “Search and Destroy” policy works rather well because the national health care network is more resilient to epidemic spread than that of other countries. • Antibiotic policies engender guidelines, not rules. 3) In clinical practice antibiotics are used according to judgement and experience and more often than not according to custom.

  10. The Dutch approach: a sceptical view 2 However: • There is a custom of antibiotic restraint in the Netherlands. • This applies to clinicians, (no AB for sinusitis and middle-ear infections) • as well as to patients, (“Niet klagen, Maar dragen”).

  11. Thank you !

  12. Structural Differences

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