Evaluation of the available apps to support the Italian physicians in the Antimicrobial Stewardship implementation

Background and Objective: Antimicrobial resistance (AMR) is a serious problem and remains one of the greatest global threats to public health at the beginning of the 21st century. As digital technologies become an important resource for healthcare delivery and public health, we decided to investigate the available apps to support Italian physicians combat AMR. Methods: A systematic research was performed by four independent researchers in the Apple and Google Play App stores using English and Italian keywords. After excluding content in languages other than Italian or English, gaming, photo and video, paid apps and contents, and advertisement, apps were downloaded and analysed using an 86-item checklist including pathogens/etiological agents, support for diagnosis and therapy, AMR, dashboard function, antimicrobial stewardship (AMS), notes and recordings, network, technical characteristics of app domains as validated by experts. Results: Of the 115 apps initially identified, 27 (6 for Android, 21 for iOS, 1 for both) were analyzed. No app met all desirable aspects; only one met 36% of the criteria. From highest to lowest scores, domains are support for diagnosis and therapy (37%), technical characteristics of the app (22%), AMS (8%), pathogens/ etiological agents (4%), notes and recordings (3%), network (2%), AMR (1%) and dashboard function (1%). Most apps support identification of the drug for targeted therapy against a specific microorganism (78%) and the ability to be used offline (81%). Conclusions: No available app was able to adequately provide the desired features. To engage all prescribing physicians in the fight against AMR and implement AMS, an app that meets all requirements must be developed.