2016 Anti-infective Guidelines App Review, Antibiotic Stewardship from Canada

Frequently, trainees ask me why they need a dedicated infectious disease guide. Why can’t they just use a drug guide such as Epocrates or Lexicomp or reference apps such as UpToDate, Dynamed or Essential Evidence Plus? Perhaps they could. The problem with drug guides is that they may not be up to date or accurate. Many found this out the hard way with the shocking removal of the app Bugs + Drugs by Epocrates. The app was simply not accurate. Embedded drug guides in Epocrates Essentials and LexiComp’s full suite are fine, but require additional purchases which may increase the cost over that of a dedicated infectious disease guide. The issue with the reference apps like UpToDate and Dynamed is that in order to find what you are looking for you have to dig through excellent but unnecessary text to drill down to the information you need.

Over the past year I have reviewed three outstanding dedicated infectious disease guides: Hopkin’s, Sanford, and the Infectious Disease Companion (IDC). Hopkin’s and Sanford each cost $29.99 which causes many students and residents and even some faculty to pause before downloading. IDC is a bargain by comparison at only $5.99 iOS/$2.99 Android. The advantage to all of these is the ability to get updates throughout the year. No more out of date paper guides. For providers in the United States, any of these three guides would be outstanding and much better than using a reference app alone. But for providers up in Canada is there an equivalent app?

In the 1990’s, providers in the US began what they termed academic detailing. Taking the Big Pharma “detailing” method, but using evidence based medicine as the message. This model was further developed by family physicians in Canada who began to “academically detail” their colleagues on comparative drug dosing. I previously reviewed one of the products of these efforts, the outstanding RxFiles. The latest efforts at taking academic detailing to new heights by improving antibiotic stewardship comes again from Canada from a group called the Partners for Appropriate Community Therapy (PAACT). This group has been active in academic detailing for years. The PAACT have published numerous guidelines for primary care providers available here, and for the first time have produced an iOS app of their latest 2016 Anti-infective Guidelines. These guidelines focus on community-acquired infections and are written by a wide-reaching group of family physicians, infectious disease specialists, pharmacists and nurses. The 2016 update covers eye, respiratory, skin, genitourinary, CNS, and gastrointestinal infections with additional sections on antimicrobial prescribing pearls and prophylaxis.

Video Review

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Evidence based medicine

The 2016 Anti-infective Guidelines app is both an evidence and expert-based app geared for primary care providers with an antimicrobial stewardship slant. Prices are included for each recommendation. The PAACT guidelines have research showing their effectiveness in reducing unnecessary antibiotic prescribing. The app does not utilize the expert guidelines from the Infectious Diseases Society of America (IDSA), but many of the recommendations are the same or similar. The app contains price comparisons for each recommendation, numerous references and clinical support tools.

What providers would benefit from this App?

Students, residents, mid-levels, hospitalists, nurses, any primary care provider who cares for patients with infectious diseases.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.