Bug & Drug

Bug & Drug App is a context-specific Infectious Diseases Clinical Decision Support (CDS) application developed to support rational and timely antimicrobial prescribing in inpatient and outpatient settings. The application assists healthcare professionals in making evidence-based decisions at the point of care, with a focus on early recognition of sepsis, appropriate antimicrobial selection, and timely initiation of antibiotic therapy. It helps clinicians identify the appropriate window for antibiotic initiation and supports compliance with the 1-hour sepsis bundle. This developmental initiative was undertaken at the Sindh Infectious Diseases Hospital & Research Centre (SIDH & RC), Dow University of Health Sciences (DUHS), Pakistan, with funding support from the Wellcome Trust and CAMO-Net under an Antimicrobial Stewardship (AMS) fellowship initiative. It is collaboratively developed by Infectious Diseases physicians, clinical microbiologists, and software developers. Clinical guidelines and evidence-based recommendations were translated into structured, algorithm-based clinical pathways to provide practical guidance at the bedside. The application is currently available for Android and iOS users and can work offline. Bug & Drug provides syndrome-based diagnostic and treatment algorithms covering a range of infectious diseases, empiric and culture-guided antibiotic recommendations, WHO AWaRe classification, renal dose adjustment of anti-microbial using creatinine clearance, IV-to-oral switch guidance, transmission-based precautions, targeted therapy based on detected resistance genes, antimicrobial spectrum and post exposure prophylaxis for different infectious diseases. It also has details related to pathogens, antimicrobials, infectious diseases, vaccination, Tuberculosis (TB), HIV and Sexually Transmitted Infections (STI). The HIV and TB sections provide information relevant to diagnosis, management, and linkage to treatment services, including information on HIV and TB treatment centres across Pakistan. It has three calculators to calculate qSOFA, NEWS2 scores and Creatinine clearance allowing healthcare professionals to perform key assessments within the same platform without relying on multiple external resources. Overall, Bug & Drug is designed as a practical, context-specific digital clinical decision support platform that integrates infectious diseases expertise, antimicrobial stewardship principles, clinical algorithms, and bedside calculation tools. Its objective is to support timely, evidence-based clinical decisions, improve antimicrobial prescribing practices, promote early recognition and management of sepsis, and contribute to efforts to combat antimicrobial resistance in Pakistan by selecting the right drug for the right bug.