Antibiotic resistance (ABR) has increased worldwide, largely because of the overuse and misuse of antibiotic medications, but if left unchecked, experts fear it could claim up to 10 million lives per annum at a cumulative cost of USD100 trillion by 2050.

The threat of antibiotic resistant superbugs is becoming increasingly common in South Africa too and it is estimated that up to 80% of all antibiotic scripts in the country are predominantly for acute respiratory tract infections like sinusitis, bronchitis and pharyngitis. These infections are mostly of viral origin and shouldn’t be treated with an antibiotic. It is estimated that 60% of these antibiotic prescriptions are inappropriate.

Misuse of antibiotics has resulted in multidrug-resistant (MDR), extensively drug-resistant (XDR) and pan-drug-resistant (PDR) bacteria, which are being reported more often in South Africa and the threat of this potentially becoming our worst nightmare was already highlighted in a 2008 publication in the South African Medical Journal (SAMJ).

According to Annemarie Blackmore, Antimicrobial Portfolio Manager at Pharma Dynamics, the window of opportunity to control ABR is rapidly closing, hence the urgency to launch interventions that will reduce excessive antibiotic prescribing.

One such intervention is the new BugWise app developed by Pharma Dynamics to support Antibiotic Stewardship programmes. The BugWise app aims to reduce the emergence of resistant bacteria, caused by inappropriate use of antibiotics, by making relevant and updated information readily available. The BugWise app was conceived and developed by Pharma Dynamics with input from a broad range of medical and IT experts.

Blackmore describes BugWise as a one-stop-app for doctors and patients alike.

“The app has been designed with the busy physician in mind and will help healthcare practitioners in private and public healthcare settings to optimise treatment while minimising antibiotic resistance. For example, doctors can input a patient’s information, such as diagnosis and chronic medications that they’re on, directly into the app and receive treatment recommendations specific to that individual. The app also allows doctors access to ABR surveillance data, which keeps them up to date on resistant strains that are prevalent in the area.”

“Patients on the other hand will be able to research information on their diagnosis, along with the medication they have been prescribed. The app will inform them about antibiotics and the dangers associated with incorrect use, as well as some useful tips on how to prevent infections. They are also able to set reminders to take their medication at the correct times.

Blackmore further highlights that health topics, such as ABR, tend to be ineffectively communicated to the public. “Since most people have access to smartphones these days, we see huge value in the use of alternative and sustainable education resources such as BugWise. Educating the public is an extremely important factor in tackling ABR, as often patients put pressure on doctors to prescribe antibiotics and may not understand that often their illness is likely caused by a virus which cannot be treated with an antibiotic.”

Blackmore says that although there are various apps that provide antibiotic information, the benefit of BugWise is in providing a single source where a doctor can find all the relevant information he/she may require on one platform, as well as an educational platform to assist with keeping patients informed. “We have consolidated this requirement by way of the app, which makes it easily accessible to doctors, no matter where they are based,” she explains.

Key features of the app include:
• general alerts around updated drug monographs;
• access to the latest medical and scientific publications and articles related to ABR;
• detailed microbe and medication information;
• drug interaction checker;
• antibiotic duplication checker;
• dosing calculators;
• and importantly, surveillance data

The BugWise app can be accessed via both android and iOS phones, and be downloaded from any app store. Patients can register immediately to access the app, while doctors can request a code via the app by providing their healthcare practice number.

Blackmore says the reasons driving excessive prescription of antibiotics are multifactorial, but perhaps most importantly, is the overlapping clinical features of viral and bacterial infections making it difficult for GPs to distinguish between patients that would benefit from an antibiotic and who wouldn’t.

“Typically, doctors would err on the side of caution by prescribing an antibiotic, but with the growing threat of ABR – already being described as the modern plague – it is critical that doctors limit the prescribing of antibiotics to only those that are most in need of it or else it could soon render antibiotics null and void. Once these strains develop in an intensive care unit, ward or hospital, endemicity is inevitable. Reported cases of ABR have already reached well beyond tuberculosis in SA, which affects an estimated 450 000 South Africans per annum, remarks Blackmore.

Professor Guy Richards, a specialist in ABR at Charlotte Maxeke Johannesburg Academic Hospital and who formed part of Pharma Dynamics’ R&D team, says BugWise can help doctors to optimise patient outcomes while minimising antibiotic resistance at the click of a button.

“We’re very excited about the app, specifically because it can be customised to include statistics for specific locations to incorporate local sensitivity patterns. BugWise makes this kind of information available to doctors in a much more efficient and accessible manner, which is ideal for busy doctors who have limited time.”

He says in addition to drug resistance, overuse of antibiotics can also lead to other health issues such as drug toxicity or complications such as C. difficile colitis. “Microbes are smart and they evolve to get around things that kill them. If ABR isn’t tackled effectively in the next few years, we are at threat of a post-antibiotic era in which minor infections and surgeries could prove fatal,” emphasises Prof Richards.

As a socially responsible pharmaceutical organisation, Pharma Dynamics continues to push the boundaries by finding solutions to critical health challenges that face our country. BugWise is another proof point of its commitment to health promotion.