Antibiotic Ninja

Last updated: May 17, 2017


The goal of this project is to create a web application that can be used by clinicians at Johns Hopkins Bayview Medical Center in order to provide antibiotic recommendations for patients affected by common infections.

  • Students: Katie Hochberg and Allie Sanzi
  • Mentors: Jennifer Townsend, Michael Cohen, and Andrew Hinton

Background, Specific Aims, and Significance

Centers for Disease Control and Prevention estimates that “up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed.” This overuse of antibiotics is a dangerous issue facing healthcare in the United States and other countries around the world. It leads to antibiotic resistance, meaning that the usual treatments for infections are no longer effective, and alternative treatments must be used. These alternative treatments are more expensive, less effective, and/or result in a greater cost to the patient. To improve the accuracy of antibiotic prescription, Antibiotic Ninja will assist healthcare providers by making an appropriate antibiotic recommendation for patients based on their history, vital signs, and lab results.


  • Minimum: Completed
    1. Documentation including use cases and exploration of external API’s
    2. Backend design for database, admin portal, and user portal
  • Expected: Completed
    1. Backend implementation for database, admin portal, and user portal
    2. Frontend implementation for admin portal and user portal
    3. Minimum viable product for testing at Bayview Medical Center
  • Maximum: Completed
    1. User Interface enhancements
    2. Decision Tree GUI Implementation Plan

Technical Approach

We are building a web application to give decision support to doctors when prescribing antibiotics. Our advisor, Dr. Jenny Townsend, has developed decision trees that healthcare providers follow when diagnosing a suspected infection patient. These decision trees will inform the underlying database structure and flow of our application. The web application will have an administrator portal, which will allow administrators to customize these decision trees, and a user portal, which will allow healthcare providers to enter patient health data as prompted and receive an antibiotic recommendation. The first thing we plan to do is explore the documentation of the external APIs that we will need to use. This will allow us to understand the interactions between our application and the external APIs so that we can create an effective design. We will continue by designing the schema for the database as well as the backend of the application. For the database, we will use a PostgreSQL database. For the rest of the stack, we will use Node.js, Express.js, and Angular.js. After creating a design for the backend, we will implement the backend of the application using iterative testing to ensure proper function. As we implement the backend, we will work with the team to turn the UI wireframes into a complete design. We will then build out the frontend of the application and create a clean user interface that is intuitive to use. If time permits, we will enhance the user interface and create an implementation plan for a graphical user interface to build decision trees.


Dependency Resolution Plan Status
Obtain decision trees Request from mentors Resolved
Obtain initial user interface wireframes Request from mentors Resolved
Documentation for epic API Explore online resources Resolved
Software needed for backend Download and/or install Resolved
External libraries for implementation Get documentation and/or install Resolved
Finalized designs for admin portal UI Iterating with mentors Resolved
JHU account authentication Work with Michael Resolved
Hosting on external server Work with Michael Resolved
Reaching out to contacts for pilot testing group Working with mentors In progress
Securing hostname for website Follow up with Dr. Townsend Resolved

Milestones and Status

  1. Use Cases and Documentation
    • Completion Date: March 5, 2017
    • Status: Completed
  2. Backend Design
    • Completion Date: March 6, 2017
    • Status: Completed
  3. Backend Implementation
    • Planned Date: April 11, 2017
    • Expected Date: April 11, 2017
    • Status: Completed
  4. Frontend Implementation
    • Planned Date: April 25, 2017
    • Expected Date: April 25, 2017
    • Status: Completed
  5. Enhancing User Interface
    • Planned Date: May 9, 2017
    • Expected Date: May 9, 2017
    • Status: Completed
  6. Decision Tree GUI Implementation Plan
    • Planned Date: May 9, 2017
    • Expected Date: May 9, 2017
    • Status: Completed

Reports and presentations

Project Bibliography

  • CDC. Antibiotic Resistance Threats in the United States, 2013. Vol CS239559-B. Atlanta, GA 2013:114.
  • Pollack LA, Srinivasan A. Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention. Clin Infect Dis. 2014;59 Suppl 3:S97-100.
  • Magill SS, Edwards JR, Beldavs ZG, et al. Prevalence of antimicrobial use in US acute care hospitals, May-September 2011. JAMA. 2014;312(14):1438-1446.
  • Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of healthcare-associated infections. N. Engl J Med. 2014;370(13):1198-1208.
  • Hecker MT, Aron DC, Patel NP, Lehmann MK, Donskey CJ. Unnecessary use of antimicrobials in hospitalized patients: current patterns of misuse with an emphasis on the antianaerobic spectrum of activity. Arch Intern Med. 2003;163(8):972-978.
  • Braykov NP, Morgan DJ, Schweizer ML, et al. Assessment of empirical antibiotic therapy optimisation in six hospitals: an observational cohort study. Lancet Infect Dis. 2014;14(12):1220-1227.
  • MacDougall C, Polk RE. Variability in rates of use of antibacterials among 130 US hospitals and risk- adjustment models for interhospital comparison. Infect Control Hosp Epidemiol. 2008;29(3):203-211.

Other Resources and Project Files

Here give list of other project files (e.g., source code) associated with the project. If these are online give a link to an appropriate external repository or to uploaded media files under this name space.

courses/446/2017/446-2017-16/project.txt · Last modified: 2019/08/07 12:01 (external edit)