Can a digital tablet cut back a country's overuse of antibiotics? toggle caption Magali Rochat During a typical day at a clinic in rural Rwanda, nurses can see 60 patients a day. Adults and children line up with injuries, coughs and fevers, often after traveling many miles. "Nurses are very busy, they're receiving all the things from the community, complicated or easy," says Dr. Victor Pacifique R...
Can a digital tablet cut back a country's overuse of antibiotics? toggle caption Magali Rochat During a typical day at a clinic in rural Rwanda, nurses can see 60 patients a day. Adults and children line up with injuries, coughs and fevers, often after traveling many miles. "Nurses are very busy, they're receiving all the things from the community, complicated or easy," says Dr. Victor Pacifique Rwandarwacu, a physician from Rwanda. That leaves little time for diagnosis. When faced with a patient suffering from an illness, many nurses err on the side of prescribing something. Often, that's antibiotics. "You find them giving a high number of antibiotics, just in case," says Rwandarwacu. "They'd be like, 'OK, what if I don't give it, and then the patient comes back tonight?'" Sponsor Message That dynamic has led to extremely high prescription rates, according to new research by Rwandarwacu and his colleagues. Across 32 clinics in Rwanda, 71% of pediatric visits ended with an antibiotic prescription. That's likely much, much higher than necessary. For a given patient, getting antibiotics for, say, a viral case of pneumonia may not be a big deal, even though antibiotics do nothing to stop the virus. But across a region or country, such high rates of unnecessary prescriptions can breed resistance . "In sub-Saharan Africa, the rise in antimicrobial resistance is enormous," says Jean Claude Semuto Ngabonziza, a researcher at the Rwanda Biomedical Center who was also involved in the study. "We are at the edge of losing potential antibiotics." But Ngabonziza, Rwandarwacu and their colleagues have developed a new tool that could help. Their computer tablet-based tool, called ePOCT+, guides clinicians, step-by-step, through diagnosing a problem and suggesting a treatment. After those same 32 clinics implemented ePOCT+, antibiotic prescription rates plummeted from 71% to 25% , the researchers report in PLOS Medicine. That drop didn't lead to more kids getting sicker. "The most ...