Scientists develop digital tool to reduce antibiotic prescriptions in children

Dar es Salaam. Scientists at Ifakara Health Institute (IHI) and the Swiss Tropical and Public Health Institute (Swiss TPH) have created a digital algorithm-based tool that can help reduce antibiotic prescriptions in children.

Antibiotic overuse is one of the major causes of increasing resistance rates among pathogens, and the use of antibiotics has been consistently rising in the past few decades.

Previous studies have shown that many consultations result in the prescription of antibiotics when there is no need for them, according to the scientists who published their findings in the renowned Nature Medicine journal on Monday after conducting a large cluster randomised trial in Tanzania.

During trials scientists observed that using a digital decision support tool significantly decreased antibiotic prescriptions for children, with no effect on clinical outcomes.

Also read: Answering challenges posed by antimicrobial resistance

To tackle the bacterial antimicrobial resistance issue, the researchers developed a clinical decision support algorithm for paediatric consultations that uses point-of-care tests to provide advice on diagnoses and related therapies according to WHO and Tanzanian clinical guidelines.

The scientists tested the tool’s efficacy in reducing antibiotic prescriptions in 20 health facilities in Tanzania, which included more than 20,000 consultations over the course of 11 months.

When the tool was used, antibiotics were prescribed in 23.2 percent of consultations, compared to prescriptions in 70.1 percent of consultations in the 20 other health facilities included in the study where the tool was not deployed.

Also read: Antibiotic resistance is the next global epidemic

“The reduction in prescriptions did not result in adverse effects for the patients, as no difference in the failure of treatment rate was observed during the study,” IHI said in a statement.

Significance of the digital tool

The researchers noted that 25 percent of the individuals in the intervention arm were not managed by the algorithm, which highlights the need for consistent use of the tool.

However, they noted that the research represents a potentially scalable solution, in terms of cost and technology, to reduce antibiotic prescriptions safely.

Clinical officer and doctor in charge of the Iganzo Dispensary, Dr Leah Rwezaula, who uses the digital tool, said the tool has helped build his capacity.

“When I am attending to a patient, it helps me treat the patient better,” he noted.

A research scientist at Ifakara Health Institute and author of the study, Dr Lameck Luwanda, said; “I believe we are making significant strides in mitigating antimicrobial resistance. The seamless integration of this tool into established platforms like GoTHOMIS and its subsequent deployment across numerous primary health facilities holds the potential to significantly enhance our ability to save more lives.”

The study, titled A digital health algorithm to guide antibiotic prescription in paediatric outpatient care: a cluster randomised controlled trial,” was conducted in Tanzania as part of a five-year research project called Dynamic, which started in 2019 and was led by Unisanté’s Digital and Global Health Unit in collaboration with several partners.