Although doctors mean well by prescribing antibiotics, we can’t ignore the fact that antibiotic resistance as an effect of overuse has become an overwhelming problem in the healthcare industry and elsewhere. The situation can appear hopeless to some, but the team at Antibiotic Adjuvant sees it as a challenge they are willing to accept. They have developed software that works with the doctor at point-of-decision, along with the patient’s specific information and information about the facility itself, transforming antibiotic use from chaos into a coordinated, conscious campaign. Using the correct methods, antibiotic resistance therefore becomes preventable. We asked David Flores, the co-founder and CEO of Antibiotic Adjuvant, and Dr. Robert Yancey Jr, the company’s co-founder and Medical Director, to tell us more about their motivation and how it all works:
How did you become interested in healthcare?
DF: When I was a little boy, I wanted to be just like my father, a doctor. However, after being in the O.R. couple of times, I decided to study something else. The bug never seemed to fade on me though. While having another business, I found myself talking to doctors and doing apps in the healthcare space. After learning about this problem from Bob, our Medical Director, I just couldn’t believe how crazy it is that antibiotic resistance is growing so rampantly, and that no one seems able to control it—even though it is preventable!
RY: I have wanted to be a doctor since I was eight years old. It is a gift and a privilege to practice medicine. Infectious Diseases is by far the most interesting sub-specialty in medicine. It is a little like being Sherlock Holmes. Seeing patients in the hospital getting substandard antibiotics so frequently made me think that there has to be a better way, and as a consequence, I have been working in the field of Antibiotic Stewardship for over 20 years.
When did you decide to start a company, and where did your team get together?
DF: Preventing the increase in antibiotic resistance is a very compelling problem that can be prevented by applying new technologies to existing systems. After doing couple of prototypes and getting good feedback from doctors and nurses, we decided it was time to tackle this problem. We started working in Gainesville, FL and relocated to San Francisco to improve our chances of making this idea a reality while doing IndieBio.
RY: I have been kicking this idea of how to codify algorithms for improved and coordinated antibiotic use for many years, after it became obvious that current methods of Antibiotic Stewardship were inadequate.
How does your technology work?
DF: We have created a software that reduces the time it takes a doctor to prescribe antibiotics, improves communications between pharmacists, doctors, and nurses; saves the hospital millions of dollars in unneeded procedures and loss of funding, and improves patient outcomes. We can do this by improving the way antibiotic stewardship programs are implemented in a health center. Our software uses input from the electronic medical records, lab reports, and other reports to provide personalized antibiotic recommendations for a particular patient and facility. We take into account the health center’s microbiome and create a coordinated antibiotic campaign to prevent antibiotic resistance from occurring in the first place. Since we are with the doctor at point-of-decision, we can affect virtually every patient in the facility and provide true comprehensive antibiotic stewardship.
RY: The basic premise is that given sufficient, easy to understand information, the busy physician will do the correct thing, especially if it is fast. In addition, modern analytics can help even the most knowledgeable physician make better decisions. The fields of Quality Assurance and Infection Prevention are enhanced by identifying and predicting all adverse events and infections in the facility, not just those with a positive culture, and their predisposing factors. Administration can identify methods to reduce costs that were not visible before. Patients have better outcomes. Win-Win!
What lessons did you learn transitioning from science to entrepreneurship at IndieBio?
DF: The main difference I see between science and entrepreneurship is the market forces. In the market, you have to take into account the feasibility of the science but also the costs to create the product. The profit margins have to be healthy, and your customers must want to use your product. The market will reward companies that take these three pieces into account when commercializing a technology/idea.
RY: Saving lives and costs is a great product, but we have to demonstrate that we can execute. IndieBio has helped us execute in so many ways. They have pushed us to be the best we can be, not just an idea.
How do you think your success as a company would change the medical industry?
DF: We will fundamentally change the way antibiotic prescriptions are made in the world. In the future, people will be able to go to the hospital and not acquire an infection while receiving treatment because health centers will not have rampant antibiotic resistance as they do today.
RY: We will transform antibiotic use from chaos to a coordinated conscious campaign to minimize resistance and complications. More intelligent antibiotic use means a safer, more effective, less costly healthcare system.
What milestones are you aiming to hit in the near future?
DF: We are aiming to arm skilled nursing facilities with tools to improve their antibiotic stewardship programs and then start doing a pilot in hospitals.
RY: Out first installation into a skilled nursing facility is underway, and we will reach at least 100 more facilities within 10 months. CMS requirements for Antibiotic Stewardship and Infection Control will drive our sales. Testing in acute care hospitals will begin in early 2019 with demonstration of financial and patient safety benefits within months after that. At that point, AA will add physicians’ offices to the campaign to monitor and control resistance in entire communities. It’s a big goal, but doable according to the CDC.