Antibiotics are important for treating bacterial infections. However, bacteria can adapt and ﬁnd ways to become resistant to antibiotic, which is direct consequence of overusing antibiotics and prescribing them inappropriately.
This means, the more we use antibiotics, the greater the chance bacteria will become resistant and will be no longer useful to treat infections.
Another problem is inappropriate and unnecessary use of antibiotics. CDC data shows that 30% of prescribed antibiotics in U.S. are unnecessary. Most of them are prescribed for respiratory conditions caused by viruses – i.e. common colds, bronchitis, and sinus and ear infections – which do not respond to antibiotics. This is also a common way of how bacteria develop a resistance to antibiotics.
To prevent antibiotic resistance, it is extremely important to use antibiotics in the right way. That means using the right medication, at the right dose, at the right time, for the right duration. Also, antibiotics should always be taken as prescribed.
Knowing how to prescribe antibiotics is much easier if you have guidelines at your fingertips. There are a lot of mobile apps with a goal of helping healthcare providers, especially those working in primary care, on how to properly manage antibiotic use.
Today, we review one of these apps called GP Antibiotics. It is a simple free pocket reference for the current NHS Greater Glasgow & Clyde antimicrobial guidelines, developed by Polwarth Medical for Android and iOS devices.
This app contains up-to-date antibiotic, antiviral, antifungal and other antimicrobial management guidelines for the infections commonly encountered in adults and children. Although made by Scottish-based institution for the healthcare providers in Scotland, GP Antibiotics app could be used by other providers located elsewhere, if they find it in accordance to their local guidelines.
Upon opening the app, you'll see that the GP Antibiotics has very simple menu, featuring Adult, Child, Important Info and About buttons only. There is also pretty basic Settings icon with only two actions, one of them being the option to disable collecting the anonymous usage data, which this app does by default.
Tapping on Adult opens the new screen featuring the list of conditions listed alphabetically, also including antibiotics that should be used to treat that condition, along with the recommendations on doses and therapy duration, as well as first-line, second-line and penicillin allergic options.
For example, if you have a patient with acute sinusitis, you'd get the recommendation to first consider delayed prescribing or avoiding antibiotics altogether, because most of the cases resolve in 14 days without antibiotics, which offer only marginal benefit.
If you decide to go on with the therapy, you'd be recommended to start 500mg of Amoxicillin, or if the patient is allergic to penicillin, to prescribe 200mg of Doxycycline for 7 days.
Tapping on each condition provides you with additional recommendations. In case of acute sinusitis you'd be advised to use adequate analgesia, consider xylometazoline nasal spray, or alternative antibiotics if the initial therapy doesn't work, i.e. if the symptoms are severe or persistent for longer than 10 days.
Recommendations for conditions can be filtered out depending on the systems affected. Tap on All Systems and change it to get guidance for different infections, including meningitis, dental, genital tract, gastro-intestinal, HIV, immunocompromised (not sure about why these two are separated), lower respiratory tract, skin/soft tissue, tropical, upper respiratory tract and urinary tract infections.
You can keep all systems on, because each condition has name of the system affected beside, with the different color code. However, choosing the system is more convenient, and you'd get recommendations much faster. Basically, it only takes three taps to get guidance on antibiotic use for certain condition, which is really great.
Besides guidelines for adults, you can also get recommendations in Child section, which works in pretty much the same way, but covering only 10 conditions, many of them lacking dosage information, referring users to BNF for Children, in order to get the dosing advice instead.
I hope dosages for children would be added in one of the future updates, because it doesn't take much effort to add existing dosing advice into more convenient mobile format.
Also, GP Antibiotics app lacks information on nephrotoxic antibiotics, such as gentamicin or vancomycin. Truth is that they are not included in the app's recommendations (they're included in separate GGC Medicines app by the same developers), but knowing that they're often prescribed for treating UTIs, pneumonia, or meningitis, this app should include them too, along with the calculators.
There is also Important Info section that provides basic principles of treatment, interactions with other medications, as well as useful reference links.
GP Antibiotics app is straightforward and very easy to use, and can come in handy in a busy primary care environment. There's a room for improvement, but these recommendations, although written for medical staff in Scotland, are worth having on your phone, as long as they're in accordance with your local guidelines on antibiotic use.
Benefit: General practitioners, physicians, junior doctors, and other healthcare professionals, especially those working in primary care