Prescribing Companion App: Leading the way in antimicrobial stewardship

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The irrational use of antimicrobials is a global challenge. Prescribing the right drugs, in the correct dosage with clear instructions, is essential for addressing infectious diseases. However, estimates suggest more than half of medicines are prescribed inappropriately, fuelling growing rates of antimicrobial resistance (AMR).

This issue is particularly acute in low- and middle-income countries where health workers often lack access to context-relevant guidelines on antimicrobial use.

To close this gap, the Commonwealth Pharmacists Association (CPA) developed the Prescribing Companion App to provide quality-assured and up-to-date guidance on prescribing medications at the point of care. The app was created as part of CPA’s Surveillance and Prescribing Support for Antimicrobial Stewardship Resource Capacity Building (SPARC) initiative, a Fleming Fund Regional Grant project.

We explore the app’s development, roll-out and growing impact on prescribing practices across human and animal health sectors.

Above image: On site promotion of the App (Credit: CPA)

Antimicrobial stewardship (AMS) is a foundational approach to preserving the effectiveness of antimicrobial drugs and strengthening health systems against AMR. With only general AMS guidelines available online, the SPARC team saw an opportunity to build a central hub for local and international antimicrobial treatment guidelines. The Prescribing Companion App was the result ─ a cost-effective, scalable platform for sharing prescribing resources with animal and human health professionals.

The app is free to download on smartphones and is accessible offline, maintaining availability in areas with unreliable internet connectivity. It hosts a core repository of prescribing guidance resources, alongside country dashboards, with toolkits covering infectious diseases, COVID-19, maternal health, animal health, and other common prescribing areas.

“The goal is to standardise care through adherence to national guidelines, while supporting less experienced health workers to prescribe confidently and improve patient care,” said Kelly Alexander, AMS Technical Lead, SPARC.

Following a pilot in Ghana, Tanzania, Uganda and Zambia in 2020, the app was scaled across 17 countries through the Fleming Fund. Since going live in November 2022, more than 80,000 health and veterinary professionals have accessed the platform. Uptake has been particularly strong in countries where CPA has an active presence and capacity to promote the app, however, users span over 200 countries globally.

One Health guidance

A defining feature is the app’s One Health approach, offering clear guidance for both human and animal health practitioners. Currently, three countries have animal health guidelines on the app, with a further three expected to launch by March 2026.

There are often fewer prescribing barriers in the animal health sector. The app supports veterinarians, farmers, and other service providers by providing specific AMS guidance to proactively address AMR in their communities.

Also, animal health guidance that is accessible to all app users promotes a better understanding of disease transmission between humans, animals, and the environment. This impact was recognised in 2025 when the app was shortlisted for the UK Health Security Agency’s Antibiotic Guardian Awards, earning the ‘Highly Commended’ distinction in the Animal Health, Agriculture & Food Supply category.

Champion model

While AMS is the app’s core focus, the platform is designed to be customised by each country, depending on their needs and to include prescribing guidelines, resources, and tools from other therapeutic areas. To help facilitate this, each of the 17 Fleming Fund-supported countries using the app has a designated champion: a trained superuser responsible for coordinating content and technical support.

“These champions work collaboratively with the app’s developers, and ministries of health and agriculture to maintain and upload contextually relevant content to country dashboards. The CPA team sees the champion model as a key element to furthering country ownership of the app’s content and management,” said Bridget Kebirungi, Programme Manager, SPARC.

As of July 2025, nine countries have developed bespoke national human health guidelines for the app. Kenya has the largest library with 31 resources and growing, including facility-based and animal health guidelines. Plans are underway to integrate e-learning training materials developed to support the implementation of the National Action Plan in Kenya into the app for dissemination and access to AMR education.

“Kenya is the first country to use the app in this way and creates an example case to other countries wanting to improve access to educational content to the healthcare workforce,” added Bridget.

Securing future development

Planning for the app’s long-term viability is now a priority, with countries further tailoring the platform to meet specific AMS needs. To support this next phase, CPA is working to secure the app’s sustainability.

“This involves strengthening government partnerships and international institutions, embedding the app within national health systems and existing capacity-strengthening programmes, and exploring affordable hosting solutions,” said Victoria Rutter, CEO, CPA. “The aim is for the app to remain a trusted, country-owned tool for prescribers well beyond the Fleming Fund timeline.”

With an ongoing App license until 2027, CPA hopes countries will have adopted the app as a core prescribing tool and be able to determine next steps, which could lead to expansion of its customisation.

“As many countries around the world confront the escalating threat of AMR head-on, the Prescribing Companion App is demonstrating how accessible, evidence-based information for healthcare professionals can improve more resilient and responsive health systems from the ground up,” added Bridget.