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Review: Epocrates Bugs + Drugs App for Combating Superbugs

With cold and flu season descending upon us, now couldn't be a better time to add the Epocrates Bugs + Drugs app to your mobile clinical resources.

In 2013, the CDC reported that an estimated 2 million people in the U.S. contract infections that are resistant to antibiotics and at least 23,000 people die as a result. Epocrates Bugs + Drugs puts a little bit of power back in the hands of clinicians who are faced with battling drug-resistant infections in their communities.

This free app provides information about the most common bacterial culture and sensitivity data patterns for urine, blood and skin infections in a specific geographic location. This information is updated daily for tracking of resistance patterns and supports prescribing decisions at the point-of-care.

Who is the App For?

Epocrates Bugs + Drugs is a point-of-care decision support tool designed for clinicians who prescribe antibiotics for their patients. This resource can provide clinicians with guidance on the best selection of antibiotic therapy while awaiting culture results.

Overview

Epocrates Bugs + Drugs is an antibiotic susceptibility application for common bacterial infections of the urine, blood, and skin. Data is geolocation-specific for a given zip code and is pulled from Athenahealth's extensive cloud-based EHR (Electronic Health Record), incorporating more than 15 million patient records.

The app provides intuitive design and one-tap access to a visual listing of bacteria observed in a given location. For added specificity, users can filter a listing by specimen type (i.e., urine, blood, skin) or change location to a specific zip code.

Features

  • Provides a tutorial after you download the app.
  • You can search by location and specimen type based on more than 6000 U.S. zip codes and more than 15 million patient records stored in Athenahealth's EHR cloud. (An "i"nformation icon in the upper left hand corner of the home page provides additional information regarding the content).
  • Identifies superbugs in the area where patients live.
  • You can select an antibiotic based on bacterial susceptibility.

Each antibiotic option contains dosing and contraindication content sourced from the Epocrates drug reference. Users can access the complete drug monograph or run a drug-drug interaction check with a one-tap link to Epocrates Rx® application (if available on your device) for quick access to point-of-care prescribing information.

Though the app is rich with features and intuitive design, it is still up to the user/clinician to determine the best treatment for a patient in their care.

Criticism

Significant criticism of the app was presented by Timothy August, PharmD in an iMedicalApps review of the initial (January 2013) release of Bugs + Drugs. Dr. August identified some compelling errors (e.g., "the app identified several organisms as susceptible to antibiotics that make no sense pharmacologically. For instance, ertapenem should not be used for Pseudomonas aeruginosa.")

Dr. August also reported that ensuing user comments about content errors received clinician attention in comments on the iTunes store and in social media, which prompted Epocrates to address errors (app update, October 2013).

This reflects both the brilliance and the dark side of mobile medical technology. In the age of super bugs, an app like this is a valuable resource in doctors' hands, especially at practices/hospitals where the antibiogram may not be frequently updated.

The speed with which errors in content can be identified by astute clinicians and reported to a developer is remarkable, demonstrating value of leveraging Big Data, and the importance of high tech/mobile lines of communication and the resources physicians have come to rely in clinical practice. Epocrates released the latest version of Bugs + Drugs in January 2014.

Cost

Free; iTunes Store

Resources

CDC Antibiotic/ Antimicrobial Resistance

Athenahealth Cloud Data

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