National guidelines for the judicious use of glycopeptides in Belgium.
OBJECTIVE
The 'HICPAC guidelines', published in the USA in 1995 stressed the crucial role of restrictive usage of glycopeptides in the strategy to limit the emergence and spread of resistant enterococci. Because controversy still remains in Belgium on the necessity and feasability of restricting glycopeptide usage, the infectious diseases advisory board (IDAB) developed a consensus statement on the judicious use of glycopeptides in Belgium.


METHODS
The literature on the indications for glycopeptide treatment was reviewed, categorized and discussed by a working party of the IDAB.Consequently, the IDAB reached consensus on the warranted indications for glycopeptide use in Belgium.


RESULTS
The opinion of the IDAB-members is reported in a consensus statement specifying the indications for treatment and for prophylaxis with glycopeptide antimicrobials, as well as the situations where glycopeptides should not be used, taking into account the specific epidemiology of bacterial resistance, the availability of antibiotics and the common prescribing practices in Belgium.


CONCLUSIONS
The IDAB concludes that restrictive usage of glycopeptides must also be a priority in Belgium. Guidelines on the judicious use of these antibiotics adapted to the national situations must contribute to this objective.
Gordts
B
B
Departments of Microbiology and Infection Control, AZ St Jan, Brugge, Belgium. bart.gordts@azbrugge.be
Firre
E
E
Jordens
P
P
Legrand
J C
JC
Maertens
J
J
Struelens
M
M
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001530:Belgium; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D006094:Gram-Positive Bacteria / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D016239:MEDLINE; D008826:Microbial Sensitivity Tests; D017334:Teicoplanin / Q000494:pharmacology; D016896:Treatment Outcome; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents; D017334:Teicoplanin