Over half of the antibiotics consumed in Cyprus are administered within hospitals. According to available data, hospital antibiotic consumption increased from 45.2% in 2011 to 56.5% in 2017, and by 2023 had reached nearly 58%, showing a steadily upward trend in recent years. Levels are expected to remain similar in the coming years, according to data from the European surveillance network ESAC-Net.
In this context of high antimicrobial use, the National Action Plan for the Prevention and Control of Infections in Healthcare Settings has been implemented, aiming to reform how public and private hospitals organise and monitor daily operations. The new Plan was developed by the Medical and Public Health Services of the Ministry of Health, in collaboration with international organisations, and aligns with the guidelines of the World Health Organization and the European Centre for Disease Prevention and Control (ECDC). It covers all healthcare structures and is directly linked to the management of hospital-acquired infections as well as addressing antimicrobial resistance. Unlike previous policies, the Plan includes specific obligations and monitoring mechanisms that directly impact the internal organisation of hospitals.
Structures within hospitals
A central element of the Plan is the mandatory establishment and operation of Infection Control Committees in all hospitals, public and private. In parallel, Antimicrobial Stewardship Teams will be created, responsible for monitoring and optimising antimicrobial use.
These structures are expected to operate continuously, with clear roles and responsibilities, and to collaborate with clinical departments, microbiology laboratories, and hospital pharmacies. The goal is to integrate infection prevention and control into everyday clinical practice, rather than treating it as a fragmented process.
Surveillance as a daily practice
The Plan places particular emphasis on surveillance of hospital-acquired infections. This includes systematic recording of bloodstream infections, Clostridioides difficile infections, surgical site infections for specific procedures, and hospital-acquired pneumonia, especially in Intensive Care Units (ICUs). Surveillance is not limited to data collection but is linked to trend analysis and feedback to clinical teams, aiming for timely intervention and improved practices.
BIOCARE
A key tool for implementing the Plan is the national electronic platform BIOCARE. Through the platform, hospitals are required to submit data on hospital-acquired infections, antimicrobial resistance, and hospital antimicrobial consumption. Each hospital will have access to its own data and relevant statistical reports, while the Ministry of Health will receive aggregated, anonymised data at a national level. According to the timeline, the core subsystems of the platform are expected to be operational by the end of 2025, with additional quality indicators to follow in 2026.
Protocols and compliance
Beyond structures and digital tools, the Plan includes ongoing training for healthcare staff on infection prevention and control. It involves updating clinical guidelines and establishing monitoring mechanisms to ensure compliance with basic practices, such as hand hygiene. Training and evaluation are part of a broader framework of multi-modal interventions recommended by the World Health Organization, emphasising systematic implementation rather than ad hoc adoption of measures.
The National Action Plan and the parallel implementation of the National Antimicrobial Resistance Strategy 2026–2030 fall within this framework, introducing binding procedures and monitoring tools within a healthcare system already facing documented challenges.