Digital Transformation of Antimicrobial Stewardship: Mobile Applications, Clinical Decision Support Systems, Artificial Intelligence, and the Future of Antimicrobial Governance
Abstract
Antimicrobial resistance (AMR) is a critical public health problem worldwide, affecting the effectiveness of available antimicrobial therapies. Antimicrobial stewardship programs (ASPs) have been successful in reducing the use of antimicrobials; however, classic stewardship strategies can be constrained by resources, time delays, and the complexity of clinical decision making. New digital health technologies have emerged over the last few years that offer the potential for improving stewardship by providing real-time decision support, monitoring and forecasting capabilities. To review the impact of digital technologies on antimicrobial stewardship, particularly mobile health apps, clinical decision support systems (CDSSs), artificial intelligence (AI), rapid diagnostics and digital antimicrobial governance. Methods: A narrative review was performed on the current literature to assess the applications, benefits, challenges and future directions of digital innovations for antimicrobial stewardship and AMR containment. Digital technologies are revolutionizing antimicrobial stewardship by enhancing the timeliness, accuracy, and scale of interventions. AI and machine learning aid in resistance prediction, optimizing empirical therapy, sepsis detection, surveillance, and antimicrobial management. Rapid diagnostics (RDT) can be integrated to achieve earlier identification of the pathogen, targeted treatment, and antimicrobial de-escalation. Data-driven decision-making and real-time monitoring are enhanced with digital surveillance platforms, supporting antimicrobial governance. However, implementation is still hindered by user adoption, cybersecurity, cost, data quality, interoperability, and infrastructure issues. An era of closed-loop stewardship models is giving way to a new era of predictive, proactive, and precision antimicrobial governance as digital health technologies, advanced diagnostics, and AI combine. These technologies can be strategically integrated to enhance antimicrobial optimization and contribute to the global fight against AMR.