Patterns of The use of an Institution-Specific Antimicrobial Stewardship Smartphone Application

Abstract

Background. Smartphones are increasingly used to access clinical decision support. National organizations such as the CDC, National Health Service, and Emergency Medicine Residents' Association, have created applications (apps) to assist with antibiotic prescribing. However, national guidelines do not account for local antibiotic resistance patterns and formularies. We developed and implemented an "antibiotic app” in Aug 2014 containing local prescribing recommendations for common infections, perioperative antibiotic prophylaxis, and the annual antibiogram. We released a new version in Oct 2016. The objectives of this study were to describe patterns of use and to assess provider perceptions of the antibiotic app. Methods. This is a cross-sectional observational study using 2 data sources. Patterns of app use were tracked via Google Analytics (December 2016 to April 2017) while provider perceptions of the app were obtained via an anonymous survey administered to hospitalists and emergency medicine interns (March 2017). Results. The antibiotic app was accessed on 1624 unique devices during the study period. The mean session duration was 2:14 minutes. The most commonly accessed content was treatment guidance for respiratory tract infections (11.5 to 15.1 sessions/ day), urinary tract infections (10.7 to 13.9 sessions/day), skin and soft-tissue infections (8.5 to 11.7 sessions/day), gastrointestinal infections (3.5 to 4.7 sessions/day), and the annual antibiogram (2.1 to 3.5 sessions/day) (Figure 1). The survey was administered to 70 providers with a 57% response rate. Eightyfour percent reported that they had ever used the app, and 84% of those considered themselves regular users. The majority of users reported that the app contributed to greater accuracy of antibiotic choice (94%) and consistency of antibiotic prescribing (81%). Overall, 91% of respondents were somewhat or very satisfied with the app (Figure 2). Conclusion. An antibiotic smartphone app was extensively utilized and widely considered helpful to providers. Smartphone apps may be an effective tool to disseminate local antibiotic prescribing guidance.