Grant: Operating Grant: Joint Programming Initiative on Antimicrobial Resistance

Antibiotics are an indispensable part of modern medicine. However, optimal prescription of these agents is becoming increasingly challenging because of the growing complexity of guidelines. With local variations in the types of bacteria causing infections and with increasing antibiotic resistance, antibiotic choices need to take into account local patterns of resistance. we propose the development and evaluation of AB-assistant, an a smartphone "app" that is customizable to local guidelines and therefore has the potential to be used worldwide, including in low- and middle income countries. Building on significant experience in the development and implementation of guidelines by the partners participating in this proposal, AB-assistant will aim to integrate the advantages of each system. Furthermore, the app will be made available for the two most common mobile operating systems:We propose to 1) develop an AB-assistant app based on an existing app with improvements to enhance antibiotic prescribing, 2) test the usability of this app in all countries involved in this proposal to overcome barriers, 3) evaluate the AB-assistant in an international, multi-centre, randomized clinical trial involving centres in five countries in different settings with appropriate antibiotic use as the main outcome, and 4) use factors identified in this study to further improve worldwide implementation of the AB-assistant.app.