The Project

Healthcare-associated infections (HAIs) are a major cause of morbidity and mortality (37,000 deaths / year in Europe) and have an important economic impact (28.4 to 33.8 billion dollars / year in the USA). Antibiotics are important in the control of HAIs, however, they are often prescribed inappropriately leading to the selection of resistant microorganisms that increase morbidity, mortality and costs.

Prevention and education are key strategies for the control of HAIs. Several measures have been described on it: hand hygiene, use of communication tools, policies for the diagnosis and therapy of resistant microorganisms, implementation of surveillance systems to antibiotics.

Antimicrobial stewardship programs are interventions designed to improve use of antimicrobials. Antimicrobial stewardship programs reduce hospital rates of antibiotic resistant HAIs and save hospitals and tax-payers money. Supported by this evidence, Antimicrobial stewardship programs have been implemented around the world.

In Portugal, despite the existence of an Infections Prevention and Control and Antimicrobial Resistance Program (, rates of HAIs, antimicrobial use and antimicrobial resistance rates are still high compared to other European countries: 10.6% versus 5.7% and 45.4% vs 35.8%, leading to resistance rates that can reaching 84.5%.

It have been described that effective prevention and control strategies are those that are well-matched with the social, educational and cultural background. Hence, we consider that a national toolkit designed to optimize the use of antimicrobial therapy adapted to the socio-cultural context is needed.

Based on that (and in the main objective of the Infections Prevention and Control and Antimicrobial Resistance Program from DGS that is to reduce, prevent and control HAIs, by implementing evidence based practices), we developed the HAITool project. The main objective of HAITool project that is to design a toolkit (as an operational framework) to support the health professional to improve the prevention and treatment of HAI and antimicrobial resistance. The toolkit will include the combination of a set of guidelines to implement Antibiotic Stewardship Programs and the support of ARTEMIS, an information systems to help on decision-making.

We expect to give an important contribution to effectively decrease the high rates of antibiotic usage and misuse, as well as antibiotic resistance associated with HAIs in Portugal and to promote the implementation of a nationwide Antibiotic Stewardship Program as a complement of the national program for HAIs control.