Antibiotics offer life-saving treatments for many infectious diseases. However, the overuse and misuse of these important medications also known as antimicrobials can lead to drug resistance, which is on the rise worldwide.
Overuse and misuse of antimicrobials can also cause other health issues such as drug toxicity, or complications of certain conditions, and may result in increased costs to the health-care system, due to prolonged hospital stays, and the treatment of secondary infections and other adverse side-effects of antimicrobials.
According to CDC, about 30% of prescribed antibiotics in the U.S. are unnecessary. Most of these are prescribed for respiratory conditions caused by viruses, which do not respond to antibiotics, such as common cold, flu, bronchitis, sinus and ear infections.
To prevent the antibiotic misuse, as well as the drug resistance, it is extremely important to use antibiotics in the right way, which means using the right medication, at the right dose, at the right time, for the right duration.
Knowing how to prescribe antibiotics would be much easier if health providers could consult guidelines for antimicrobials stewardship at their convenience. Mobile technologies enabled that.
There are many mobile apps nowadays that healthcare providers, especially those working in ICU and primary care, can utilize to properly manage antimicrobial use at the point of care.
We already reviewed two such apps. First was the MicroGuide app, a guide to the treatment of common infections and safe prescribing of antibiotics, and another was GP Antibiotics app, an up-to-date reference for the current antimicrobial guidelines.
The app we review today works in a similar way. Spectrum – Antimicrobials app is a customizable point of care tool for local antimicrobial stewardship designed to help providers optimize patient outcomes while minimizing antibiotic resistance.
The app is available for free download for Android and iOS devices.
Upon opening the app, users are asked to choose their location, which enables the app to customize guidelines for a specific location.
Currently, customizable profiles are available for hospitals throughout Canada and US, including Alberta Health Services Calgary Zone, Alberta Children's Hospital, Fraser Health, UCLA Health, and more.
Users can also email the app developers asking them to add their location, or they could try to test their current location which requires location ID and admin access.
Each guideline takes approximately 10-30 seconds to download and that would require an Internet connection.
After the guideline has been downloaded, the app would open the main page featuring three options including Syndromes, Pathogens, and Antimicrobials. As you could guess, these sections contain antimicrobial guidelines based on medical conditions, pathogens that cause them, and the common antibiotic medications used in the treatment.
These guidelines are presented in an algorithmic format and can include individualized patient factors to provide tailored recommendations, based on the institution chosen.
This enables healthcare providers to easily and directly input patient information into the app and receive treatment recommendations specific to that patient and their institution
The content within the guidelines vary from institution to institution, but most of the information, especially about drugs is presented in a similar format.
For example, if you've chosen Alberta Calgary Zone (if you're employed there), the recommendations for syndromes would include guidelines from Day 3 Bundle to Clostridium difficile infection to Vascular catheter infection.
If you work for one of the Fraser Health's centers, the interface would be somewhat different, grouping the syndromes in adult, pediatric, and neonatal categories.
UCLA Health guideline omits some of the syndromes listed in other guidelines, but also includes others that are not mentioned in other guidelines (such as tuberculosis). It also provides additional pathogens or medications that aren't available in recommendations of other institutions.
You can change the institution and respectable guidelines at any time in the Settings.
Guidelines would provide users with concise information, which is easy to access thanks to the simple app's interface.
Here, you'd get recommendations for diagnosis, microbiology, treatment, including empiric regimens, duration of therapy, and many more.
The most important thing is that providers get recommendations on exact antimicrobials to use for particular conditions.
The medication page contains concise information on oral bioavailability, cost, C. difficile risk (low, medium, high), the general spectrum of activity, antibiograms, dosing along with hepatic and renal functions, as well as general information about the drug, including usage, adverse effects, interactions, pharmacology, and more.
Some of the guidelines also include calculators that allow input of patient-specific factors in order to get treatment recommendations, such as guidelines for C. difficile infection or secondary peritonitis.
What would I like to see improved is interlinking the antimicrobials in Pathogens section. Currently, when you open any pathogen, under the treatments you'd see recommended medication only listed but not linked to the Antimicrobials category. It would be more convenient if they are interlinked.
Overall, Spectrum – Antimicrobials is a tremendous app that any provider that administers antimicrobials should have installed on their mobile device. Especially those providers who work for one of the institutions listed in the app.
Others could also benefit from the recommendations provided in the app, but only if they match their institutional guidelines.
Benefit: Healthcare providers administering antibiotics to their patients would benefit from this app