Use of stewardship smartphone applications by physicians and prescribing of antimicrobials in hospitals: A systematic review

Background Antimicrobial stewardship (AMS) programs promote appropriate use of antimicrobials and reduce antimicrobial resistance. Technological developments have resulted in smartphone applications (apps) facilitating AMS. Yet, their impact is unclear. Objectives Systematically review AMS apps and their impact on prescribing by physicians treating inhospital patients. Data sources EMBASE, MEDLINE (Ovid), Cochrane Central, Web of Science and Google Scholar. Study eligibility criteria Studies focusing on smartphone or tablet apps and antimicrobial therapy published from January 2008 until February 28th 2019 were included. Participants Physicians treating in-hospital patients. Interventions AMS apps Methods Systematic review. Results Thirteen studies met the eligibility criteria. None was a randomized controlled trial. Methodological study quality was considered low to moderate in all but three qualitative studies. The primary outcomes were process indicators, adherence to guidelines and user experience. Guidelines were more frequently accessed by app (53.0% - 8