AMS V2

AMS Guideline Framework

Phase 1: Rule-Based

Welcome to the Antimicrobial Stewardship (AMS) Hub

This tool synthesizes global AMS guidelines (WHO AWaRe, CDC, ICMR, NICE) into actionable, role-based insights. Select your role to see relevant principles and actions, or use the tools to support clinical decisions.

Phase 2: Upgrade Plan

This rule-based app is the foundation. **Phase 2** will integrate an LLM to provide:

• Natural language queries for complex clinical scenarios.
• Analysis of local antibiogram data.
• Personalized, real-time decision support and DDI checks.
• Automated reporting and audit feedback generation.

Select Your Role

Doctor / Prescriber

Get guidelines for diagnosis, empiric therapy, de-escalation, and documentation.

Pharmacist

Focus on formulary management, dose optimization, IV-to-PO conversion, and audits.

Microbiologist

Guidelines on specimen collection, rapid diagnostics, antibiogram creation, and selective reporting.

Nurse

Best practices for timely administration, monitoring for adverse effects, and patient education.

AMS Lead / Committee

Actions for program implementation, leadership engagement, policy creation, and reporting.

Administrator

Ensuring accountability, allocating resources, and integrating AMS with quality improvement goals.

Stewardship Tools

Antibiotic Calculator

Get evidence-based empiric therapy recommendations based on clinical scenario and patient factors.

Surgical Prophylaxis

Check standard antibiotic prophylaxis guidelines for common surgical procedures.

IV-to-PO Switch Guide

Review clinical criteria for switching to oral therapy and see common drug conversions.

Demo Antibiogram

View a sample hospital antibiogram to understand local resistance patterns.

Guideline Library

Access direct links to the source guidelines from WHO, CDC, ICMR, NICE, and more.

Antibiotic Therapy Calculator

Provides *example* recommendations based on synthesized guidelines. **Not a substitute for clinical judgment.**

Clinical Condition -- Select Condition -- Community-Acquired Pneumonia (Mild) Community-Acquired Pneumonia (Severe) Hospital-Acquired Pneumonia (HAP) Ventilator-Associated Pneumonia (VAP) Uncomplicated UTI (Cystitis) Complicated UTI (Pyelonephritis) SSTI - Mild (Cellulitis/Abscess) SSTI - Severe (Necrotizing) Intra-abdominal (Mild-Mod, Community) Intra-abdominal (Severe, HCA)

Clinical Setting Outpatient Inpatient (Ward) Inpatient (ICU)

Culture / Microbiology Data Empiric (No culture data) Gram Stain: GPC in clusters (Staph likely) Gram Stain: GNR (Gram-neg rod likely) Final Culture: MSSA Final Culture: MRSA Final Culture: Pseudomonas aeruginosa Final Culture: ESBL-producing organism

Patient Data (Optional)

Age (yrs)

Weight (kg)

Height (cm)

SCr (mg/dL)

Gender Male Female

Location North America / Europe Southeast Asia China Middle East

Allergies & Risk Factors

Penicillin Allergy Sulfa Allergy Immunocompromised Pregnant MRSA Risk Pseudomonas Risk Seizure Disorder QTc Prolongation Risk Abx in last 90d

Calculated Patient Data

BMI -- kg/m²

BSA -- m²

Est. GFR -- mL/min

Primary Recommendation

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Secondary Recommendation

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Rationale

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Recommended Duration

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Stewardship Review Plan

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Clinical Warnings

Dosing & Adjustments

WHO AWaRe Classification

Access - First-choice, lower resistance potential.

Watch - Higher priority, use with caution.

Reserve - Last-resort, for MDR organisms.

Surgical Prophylaxis (SCIP) Guide

Guideline-based recommendations for common procedures. Always confirm with local policy.

Select Procedure Type -- Select Procedure -- Cardiac (e.g., CABG, Valve) Vascular (e.g., Arterial Bypass) Neurosurgery (e.g., Craniotomy) Orthopedic (Joint Replacement) Orthopedic (Other, e.g., ORIF) Colorectal GI - Upper (Gastroduodenal) Hysterectomy (Abdominal/Vaginal) C-Section

Primary Regimen

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Penicillin Allergy Alternative

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Timing & Dosing Notes

IV-to-PO (Oral) Switch Guide

A key stewardship intervention. Review clinical criteria and common conversions below.

Clinical Criteria for Switching

• Clinical improvement observed (e.g., resolution of fever, normalizing WBC).
• Hemodynamically stable (normal heart rate, blood pressure).
• Afebrile for > 24 hours.
• Able to tolerate oral intake (no NPO status, vomiting, or malabsorption issues).
• Specific infection does not require prolonged IV therapy (e.g., endocarditis, osteomyelitis, CNS infection).
• A suitable oral agent with high bioavailability is available.

Common IV-to-PO Conversions

IV Agent	Oral Equivalent	Bioavailability
Levofloxacin	Levofloxacin	> 99%
Moxifloxacin	Moxifloxacin	~ 90%
Doxycycline	Doxycycline	> 95%
Metronidazole	Metronidazole	> 99%
TMP-SMX	TMP-SMX	~ 95%
Linezolid	Linezolid	100%
Fluconazole	Fluconazole	> 90%
Ciprofloxacin	Ciprofloxacin	~ 70-80%
Ampicillin	Amoxicillin	~ 80-90%

Demo Antibiogram - Sample Hospital (2023)

This is a *sample* antibiogram showing % Susceptible (S). Used to guide empiric therapy.

Organism (Urine)	#	Amp/Sul	Cefazolin	Ceftriaxone	Cipro	Nitro	Pip/Tazo	TMP/SMX
E. coli	452	68%	82%	85%	70%	96%	92%	74%
K. pneumoniae	188	60%	79%	81%	78%	N/A	90%	79%
P. mirabilis	92	75%	88%	89%	80%	R	94%	81%

High Susceptibility (> 90%) - Good empiric choice.

Low Susceptibility (< 80%) - Poor empiric choice.

R: Intrinsic Resistance. N/A: Not Typically Tested.

Guideline Library

Direct links to the source guidelines and resources used in this application.

WHO AWaRe Classification (2023)

The 2023 WHO AWaRe classification of antibiotics for evaluation and monitoring of use.

CDC Core Elements of AMS

The US CDC's practical framework for implementing AMS programs in various settings.

ICMR AMS Guidelines (India)

Indian Council of Medical Research's hub for AMR and stewardship guidelines.

NICE (UK) Guideline [NG15]

The specific NICE guideline covering antimicrobial stewardship in health and social care.

IDSA/SHEA AMS Guideline

The joint IDSA and SHEA practice guideline on implementing AMS programs.

ESCMID AMS Topic Hub

European Society of Clinical Microbiology and Infectious Diseases topic page for AMS.

This is a demo application for educational and illustrative purposes. Not for clinical use. All recommendations are rule-based examples.