DUHS launches tool for infectious-disease care

‘Bug & Drug’ aims to support evidence-based treatment and responsible antibiotic use


IV Report

KARACHI: The Dow University of Health Sciences (DUHS) has launched a locally developed clinical decision-support application aimed at helping doctors make evidence-based decisions in the treatment of infectious diseases, with its developers and health experts also highlighting its potential role in promoting responsible antibiotic use and addressing antimicrobial resistance (AMR).

The “Bug & Drug” application was formally launched by DUHS Vice Chancellor Prof Nazli Hossain at the auditorium of the Sindh Infectious Diseases Hospital & Research Centre (SIDH&RC), while former DUHS vice chancellor Prof Muhammad Saeed Quraishy inaugurated its publication.

Addressing the ceremony, Prof Saeed Quraishy said recurrent infections remained an important clinical challenge and expressed the hope that the application would be widely utilised by healthcare professionals. He also acknowledged the need for practical tools that could support clinicians dealing with infectious diseases and complex treatment decisions.

Prof Nazli Hossain said the initiative was particularly relevant because the number of infectious-disease specialists in Pakistan was limited, making it difficult for smaller and secondary-care hospitals to have such expertise available at all times.

In such circumstances, she said, the application could provide doctors with evidence-based guidance at the bedside. She stressed, however, that the tool should be regularly updated according to data generated by local hospitals.

Prof Hossain suggested that a short tutorial on its use be made available on the university's website to facilitate wider adoption. She also highlighted its possible application in conditions including puerperal sepsis and said its role in secondary-care hospitals should be explored.

Explaining the concept behind the application, Dr Muneeba Ahsan Saeed said its name reflected its basic purpose — identifying the infectious organism, or “Bug”, and selecting the appropriate “Drug”. The application contains information on 113 infectious diseases, 141 aetiological agents and 75 antimicrobials, she said.

The developers emphasised that the application had been designed according to Pakistan's medical and local context while incorporating international standards. Dr Muneeba Ahsan Saeed and Dr Fizza Farooqi said its purpose was to support, rather than replace, specialist clinical judgement.

The public-health significance of such support lies partly in the appropriate use of antibiotics. Unnecessary or inappropriate antimicrobial treatment contributes to the development and spread of resistant organisms, while delays in treating serious infections can increase the risk of complications. Antibiotic selection and dosing may also need to take account of the suspected organism, culture results, antimicrobial susceptibility and individual patient factors.

During a demonstration, the developers showed features intended to assist clinicians with these decisions. The application includes a Quick ID Consult and a Creatinine Clearance calculator, while the NEWS2 tool helps assess a patient's clinical risk. The application also provides guidance on when antibiotics should be initiated in cases of sepsis.

The renal-function calculator can support antimicrobial dosing decisions in patients with impaired kidney function, while its Culture-Guided Therapy component provides a prioritised list of possible medicines based on the site of infection, culture findings, identified organism and antimicrobial susceptibility.

Another section deals specifically with AMR, providing information on resistant organisms, associated resistance genes and possible treatment options.

Prof Dr Syed Faisal Mahmood described infectious diseases as a complex area in which clinical decisions could be difficult because of the wide range of microorganisms, antimicrobial choices and patient-specific considerations. He said the application had been developed with local organisms, diseases and available medicines in mind, distinguishing it from international reference resources that may not be specifically tailored to Pakistan.

He encouraged healthcare professionals to use the application and provide feedback so that it could be improved.

SIDH Medical Superintendent Dr Abdul Wahid Rajput said AMR was a major global health challenge and stressed the importance of evidence-based clinical decision-making and responsible antimicrobial use. Dr Izhar Hussain said Pakistan needed a national antibiogram and standardised therapeutic guidelines based on local evidence.

He also pointed to the wider dimensions of AMR, saying inappropriate antibiotic use was not confined to human health but was connected with animals and the environment. The declining pace of development of new antibiotics, he added, made research increasingly important.

The app's developers said local data would therefore be important to its future development. Prof Hossain also stressed the need to determine whether its use should remain primarily hospital-based or eventually draw on wider city and regional data.

Beyond antimicrobial treatment, “Bug & Drug” includes information intended to support several areas of infectious-disease care. Its sections cover HIV and tuberculosis treatment centres in Pakistan, symptom-based diagnosis and management of sexually transmitted infections, including partner management and follow-up, and vaccination information covering schedules, administration and possible adverse effects.

Dr Asma Naseem stressed the importance of awareness and outreach among doctors, particularly in public-sector hospitals. She said wider use could generate both greater benefit and useful feedback for further development.

The application also includes a bug-reporting facility through which users can report errors, information gaps and suggestions to the development team.

The speakers described “Bug & Drug” as an evolving platform that could be expanded in line with local antibiograms, emerging evidence, clinical requirements and user feedback.

At its core, the initiative reflects a broader need beyond any individual digital tool: strengthening local evidence for infectious-disease treatment, improving timely recognition of serious infections, and ensuring that antimicrobial medicines are used when they are needed and in ways that help preserve their effectiveness.

Photos: DUHS

 

With an uninterrupted 23-year career in daily journalism (1991-2013), the author/editor of this blog currently serves as Editor of Social Track, a weekly newspaper focused on social sectors, based in Karachi. Holding a master's degree in Mass Communications from the University of Karachi (1990), his professional experience includes roles as senior reporter at Daily Dawn, Karachi (May 2001-August 2013) and Chief Reporter at The News International, Karachi (April 1991-May 2001). He has a strong background in development journalism, he has an extensive portfolio of news stories, analytical reports and features covering a wide range of sectors. He has had the privilege of covering numerous high-profile figures, including Pakistani presidents, prime ministers, army chiefs, foreign dignitaries, and VVIPs and attending conferences and workshops abroad. He began his journalism career in the early 1980s. Throughout his career, he has received several national awards from government and private organisations. He has contributed to various radio and TV/channel broadcasts and has also served as a trainer at workshops in Karachi, Lahore, and Islamabad, focused on training journalists.

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