Antibiogram app for hospitals and how the best options compare for stewardship teams putting local data on prescribers' phones
Every antibiogram app on the market displays a table your team supplies. Here is how Sanford Guide Stewardship Assist, Firstline, the EHR and home-built apps compare, and where the numbers have to come from first.
7 min read
An antibiogram app puts your hospital's susceptibility data on prescribers' phones at the moment they choose an empiric antibiotic. For a US hospital the realistic options are Sanford Guide Stewardship Assist, Firstline, an antibiogram view inside the EHR, or an app the hospital builds itself. None of them calculates the antibiogram from your lab data. Each one displays numbers your stewardship team supplies, so the table has to be built correctly before any app is worth buying.
This comparison is for the stewardship pharmacist or infectious diseases physician who has been asked to "get the antibiogram on people's phones", and for the pharmacy director who will sign the contract. Everything about each vendor below comes from its own published material, named inline so you can check it.
Why hospitals want an antibiogram app at all
The PDF antibiogram is rarely read where it matters. Tallman and colleagues (Infection Control and Hospital Epidemiology, 2018) found that about 90% of medical residents knew their institution had an antibiogram, but only 44% knew how to reach it when they were actually prescribing. A table behind an intranet login is a table nobody opens at 2 a.m.
A phone app changes the access problem. At Walter Reed, Brooke and colleagues (Antimicrobial Stewardship and Healthcare Epidemiology, 2022) reported, in before and after surveys, that antibiogram use during prescribing decisions among internal medicine trainees rose from 34% to 90% after the hospital put its antibiogram and guidance into a smartphone reference app with education. It is a single-site survey result, but it is the clearest published signal that delivery matters as much as the data.
The antibiogram apps US hospitals use
Sanford Guide Stewardship Assist puts a hospital's own guidelines and antibiograms inside the Sanford Guide app and website that many clinicians already carry. Sanford says every license includes system-wide access to the full Sanford Guide content, onboarding, migration of your existing guidelines and antibiograms by its in-house PharmD-led team, usage analytics and ongoing support, with launch measured in weeks. The appeal is that prescribers do not have to adopt a new app. Pricing is not published; it is quoted after a demo.
Firstline, made by Spectrum Mobile Health and launched in 2014 as Spectrum MD in Calgary, is a stewardship app built around local guidelines. It runs on iOS, Android and the web, works offline, and its stewardship page says a customer can deliver its antibiogram "for as many hospitals, populations and pathogens as you like" and update it as often as data is generated, with import tools for the data. The NYC Health Department used Firstline for its citywide regional antibiogram, stratified by borough, age group and care setting. The app is free to download; institutional content is set up with the vendor and the price is not published.
The EHR is the third route. The Children's Hospital of Philadelphia described an electronic antibiogram embedded in its EHR with visual analytics software, on a rolling twelve months of data refreshed monthly and filterable by specimen source, unit and infection type (Simpao et al., Applied Clinical Informatics, 2018). It is excellent when it exists, and it needs an informatics team to build and maintain it.
Finally, some hospitals build their own app. The University of Iowa Hospitals and Clinics published its implementation of a customizable mobile decision support tool for antimicrobial guidance, and several community hospitals have done the same with a small vendor or a resident project. A home-built app is cheap to start and expensive to keep current once the person who built it moves on.
Antibiogram apps side by side
| Option | What prescribers see | Where the numbers come from | Platforms | Published price |
|---|---|---|---|---|
| Sanford Guide Stewardship Assist | Your guidelines and antibiogram inside Sanford Guide | Your antibiogram, migrated by Sanford's team | iOS, Android, web | No, demo first |
| Firstline | Your guidelines, formulary, antibiogram and calculators | Your antibiogram data, loaded with Firstline's import tools | iOS, Android, web, offline | No, app free to download |
| EHR embedded antibiogram | Filterable antibiogram inside the chart | Informatics build on lab data | Wherever the EHR runs | Internal build |
| Home-built app | Whatever the team designs | Whoever maintains it | Usually one platform first | Staff or contractor time |
| Antimicrobe (builds the numbers) | Print page and CSV for any of the above | Your LIS export under CLSI M39 rules | Web workspace for the team | $249 Lab, $749 Stewardship |
Every antibiogram app needs the antibiogram built first
This is the part vendor demos skip. An app is a delivery channel. If the table you load counts repeat isolates from the same patient, reports a percentage on eleven isolates, or mixes urine and blood E. coli in one row, the app delivers that error faster and to more people.
Antimicrobe sits upstream of the app. You upload the susceptibility CSV your lab already exports, it applies the CLSI M39 rules (first isolate per patient, no percentage on fewer than 30 isolates), and your team filters the result by source, period and unit until it agrees which views go out. The print page and CSV are then what you hand to Sanford, Firstline, the intranet or the pocket card. Next year the same export rebuilds the same views in minutes instead of weeks.
How the filterable team view works is covered on interactive antibiogram software, and the counting rules on CLSI M39 antibiogram software. If the job is just the yearly table, the antibiogram generator is the shorter path.
How much does an antibiogram app cost?
Neither Sanford Guide nor Firstline publishes institutional pricing, so expect an annual license quoted after a demo, usually sized by beds or users. An EHR build costs analyst time rather than a license, and a home-built app costs whatever it takes to keep it current. Ask every vendor whether loading next year's antibiogram is included or billed as a service.
Building the numbers is a separate line. Antimicrobe's Lab plan is $249 a month for one facility and two seats, bought by card on the site, and Stewardship is $749 a month for up to three facilities with unit and syndrome cuts. Annual billing is half the monthly price.
The full cost picture for antibiogram work, including enterprise platforms, is in how much antibiogram software costs, and plan limits are on the pricing page.
Which antibiogram app is best for a community hospital?
For most community hospitals the best antibiogram app is the one prescribers already open. If your clinicians use Sanford Guide, Stewardship Assist puts your table there without asking anyone to install something new. If you want an app built around your own guidelines, calculators and several facilities, Firstline is designed for that. Either way, budget for producing a correct antibiogram each year, because both display what you give them.
A critical access or small community hospital with too few isolates for a full table should fix the data problem first, often by pooling years or joining a regional antibiogram, before paying for a delivery channel.
Small hospital options are covered in critical access hospital antibiogram and regional antibiogram software for health systems.
Questions to ask before choosing an antibiogram app
Before you buy, find out whether access is really the problem. A five question prescriber poll built in any survey software will tell you whether residents can find the current antibiogram, which app they open first, and whether they trust the numbers. Then ask each vendor the questions below.
- Who loads next year's antibiogram, and is that included in the license?
- Can it show separate tables by unit, specimen source and facility?
- Does it show how many isolates sit behind each percentage?
- Does it work offline and inside the EHR, or only as a separate app?
- What usage data do we get back for stewardship and accreditation reporting?
- What format does it import, and can our CSV go straight in?
Related on this site: interactive antibiogram software, antibiogram generator, hospital antibiogram, how much antibiogram software costs, Antimicrobe pricing.