by: Michael Wong, MD
Android app Drugs and Bugs, from the developers at Monthly Prescribing Reference, provides information regarding antibiotic sensitivity for a very comprehensive list of pathogens and antibiotics, focusing on antibiotic pathogen coverage, side effects, dosing, and preparations. MPR not only offers large amounts of content on their 3.1 MB sized app, but also provides useful tools such as drug class coverage charts and commonly used calculators for on-the-spot use.
Although still relatively new in the Android market, the 3.2.2 version of the app is solid, well constructed, and beautifully designed. Never has the app crashed or paused on me during my use. All the data is stored locally on the phone, which allows quick access to the content without a network connection. Almost every text or reference is linked to its corresponding page, which makes browsing seem really snappy and fast.
Different pages are interlinked, and you will find almost everything clickable. This app does not disappoint in personalization and includes History and Bookmarking functions as well. Presentation is sharp and crisp in this minimalistic designed app with unique dark-yellow and blue color shading that–almost forcefully–reminds that you are in Infectious Disease territory now.
When browsing through different microorganisms, information is presented in a neat and concise manner. When browsing through medications, you are first presented with preparation types and a list of sensitive bacteria after the first jump. Further navigation into the specific antibiotic preparation of interest presents you with an astounding amount of detailed information, such as dosing, administering instructions, side effects, drug interactions, lab interactions, and manufacturer(s).
The app does have its letdowns. Under the “Bugs” category, certain diseases are included under this list, but somewhat sporadically. A search for pneumonia will provide you a list of possible pathogens, but a search for cellulitis or otitis media is lacking, and a click on diarrhea will bring you straight to Clostridium difficile.
The lack of viruses and parasites was disappointing as well. Under each organism, information is rather scarce and only bacteria class and sensitive antibiotics are shown here. As for the antibiotics, this app does not shy in providing detailed info, but you may need to search and dig because the core of the content is not exactly where you would expect it to be, but tucked away deep within the app.
The charts included are thorough and definitely impressive, but other than being useful as a reference chart for academic purposes, I find the charts lacking in utility in a clinical setting.
Clinical Use
At first, I was looking for an app to help me choose antibiotics to use for patient care. “Drugs and Bugs” caught my eye not too long ago on the Android Play market. However, I soon realized rather than being a clinical tool, this app is largely a reference database, more apt to help you double check your clinical judgments and antibiotic choices.
When taking care of an infection in a patient, most culture reports start by reporting gram stain results. Afterwards, perhaps a certain bacterial genus is identified. Soon after, the actual organism is grown and sensitivities specific to that organism are reported. With the lack of categorizing the bacteria further into their morphology, and the lack of searching or navigating the list by gram stain, the utility of this app and its content is greatly compromised. Only after the infecting organism is identified in the patient will this app be handy for antibiotics suggestions, but by that time, sensitivities reports are usually ready for review.
If searching antibiotic coverage based on gram stain was available, this app would perhaps become a useful tool and be utilized much more in a real world situation, especially when confronted with complicated patients with allergies,renal issues, or liver disease.
Another possible improvement that the app may benefit from is adding the ability to combine multiple antibiotics and check for pathogen coverage. This function should be useful when broad spectrum antibiotic coverage is needed and cultures have been negative, which is a common scenario in the hospital.
However, with so much detailed information on the antibiotics, such as preparations, and how to administer the medications, I can see how this app may still be useful for prescribing antibiotics in outpatient settings, and also for nursing staff and pharmacists as well, whom may rely more on the preparations and administration of medications.
Price:
- $5.99 in Android Market
- Wide range of detailed information related to each antibiotic
- Clear concise information related to antobiotic therapy
- Comprehensive range of information on various antibiotics
- Information locally stored
Dislikes
- No ability to search by gram stain
- Lack of viruses and parasites and certain bacterial pathogens
- Would like the ability to combine multiple antibiotics and determine efficacy
Conclusion:
- This app definitely provides a lot of unique information regarding antibiotics and bacteria sensitivities, but presents itself rather like a database, rather than an interactive tool. There is definitely a discrepancy in information compared to the actual MPR website as well, and that gap limits the app’s functionality and use
- I think this app has potential, but at this point in time, it is rather premature, especially for a 5.99 USD price tag (FYI, 1.99 USD on iTunes)
- With a little more categorization and organization, and perhaps a touch of some interactiveness, i.e. option to combine antibiotics and checking pathogen coverage, I can see this app being an amazing tool that clinicians would employ.
