There are now several smartphone apps available for anti-microbial prescribing. Some of these can even be programmed with your institution’s local guidelines. Locally, we use the “Microguide app”

However as far as I am aware, the apps currently related to antibiotic prescribing do not intake/process patient information. (Please correct me if I am wrong on this.)

But that is the next step…

Two key questions related to good antibiotic stewardship are as follows:

• Based on the clinical findings, does this patient actually need an antibiotic?
• If so, which antibiotic would be best ?

Humans are generally good at writing antibiotic guidelines. However they are not so good at following them. That’s because lots of other things get in the way, such as emotion, past experience, fatigue, and the desire to do everything possible to help the patient in front of them.

It will only be another few years before apps designed to answer these questions will be available. They might be rudimentary to start off with, but it won’t be long before they become sophisticated and will be every bit as competent as physicians are at making most of the routine decisions. (Think about chess computers…)

I am sure these guidelines will require regulatory approval (FDA, etc.) and it will be interesting to see how these bodies approach such apps.

In 2050, I will be 77, and coming up to the (revised) retirement age. In 2050, clinical decision making apps in all branches of medicine will be commonplace, I am sure of it. Computers are (at present) unemotional, and therefore very well placed to perform this job of deciding who exactly needs an antibiotic, and if so, which one.

However I suspect such apps will be in everyday use long before 2050…

Michael