Faced with innumerable micro-organisms, evolving susceptibility patterns, and patient antibiotic allergies, clinicians –especially those in training like myself—often struggle with antimicrobial regimen choices in the management of infectious diseases, in both the inpatient as well as outpatient settings.

What antibiotics should I order (or not order) for a penicillin-allergic postpartum patient with a fever, a hypotensive nursing home resident with a sacral ulcer, an otherwise healthy middle-aged man with dysuria, a diabetic with foot cellulitis, or a cystic fibrosis patient with an infiltrate on chest x-ray?

Borm Bruckmeier Publishing LLC, founded in 1992 by two German physicians, has brought us the expansive I-Pocketcards series of apps for the iPhone/iPad, including the most recently reviewed Smoking Cessation I-Pocketcards. To assist in clinical decision making, Borm Bruckmeier Publishing LLC has developed an I-Pocketcards App for Antibiotics.

This app, authored by Prof Dr. Herbert Hof and Ryan Knueppel, is meant as a point-of-care resource to aid healthcare providers with infectious diseases management, especially the selection of appropriate antibiotics.

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As we’ve grown accustomed to throughout the i-Pocketcards series, the user interface is simple and streamlined. The home screen features links to the table of contents, the “Classic View,” BB (Borm Bruckmeier) iTools, and “About Us,” with these links also featured along the bottom index bar.

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The table of contents features five sections, which are expandable into their corresponding sub-sections directly from the table of contents screen:

  • Empiric Therapy
  • Multi-resistant Bacteria
  • Spectrum of Bacteria
  • Antibiotic Spectrum
  • Antibiotics

The “Empiric Therapy” sub-sections are arranged by organ systems. Here, the gastrointestinal tract sub-section lists common GI infections, such as peptic ulcer disease (presumably helicobacter pylori), cholecystitis, diverticulitis, etc., as well as sample antibiotic regimens to use for treatment.

However, this guide does not list dosages or treatment duration or route. Note that navigation is made easy with the use of arrows to browse, as well as buttons to move back to the parent section.

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The “Spectrum of Bacteria” section lists micro-organisms with their gram-staining status and antibiotics, organized by first-choice, alternative, effective, low effectiveness, and not recommended.

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The “Antibiotic Spectrum” section lists antibiotics with corresponding micro-organisms, divided into first-choice, alternative, effective, low effectiveness, and not recommended, similar to the spectrum of bacteria section.

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Finally, the antibiotics section of the app can be used to reference the dosages, costs, bioavailability, elimination, penetration, and adverse effects of various antibiotics. Unfortunately, looking up this information for a single antibiotic requires navigating through each of these screens (unless using the Classic View), as the app lacks a dedicated antibiotic drug reference with this information sorted by antibiotic.

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The Classic View features the pocketcards that are the trademark of this series of apps. Here, the third of four pocketcards in the Classic View does offer a useful table not present in the “other” view of the app—an antibiotic spectrum table plotting the efficacy of antibiotics against organisms.
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The BB (Borm Bruckmeier) iTools link serves as an advertisement for the various BB apps available in the App Store.

Pricing:

  • The Antibiotics I-Pocketcards App costs $2.99 at the iTunes store.

Likes:

  • Simple no-frills user interface we’ve come to appreciate from the i-Pocketcards series
  • Inexpensive

Concerns:

  • The app does not list the qualifications or academic affiliations of the two authors (Prof Dr. Herbert Hof and Ryan Knueppel)
  • No dedicated antibiotic drug reference for easy referral
  • “Empiric therapy” section does not display antibiotic dosages, durations, or routes

Conclusion:

  • Because of the complex nature of infectious diseases and its lack of more in-depth information, the Antibiotics I-Pocketcards App does not quite lend itself to as much utility as a point-of-care resource as its i-Pocketcards series brethren
  • Nonetheless, it can still serve as a basic resource to educate students and trainees in selecting appropriate antibiotic regimens for different infections and micro-organisms

iTunes Link