Enrique Castro-Sanchez discusses our smartphone-based gaming app

Enrique Castro-Sanchez discusses the 'On call: antibiotics' prescribing game
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Increasing antimicrobial resistance has been identified as a global threat to health, and a variety of measures to encourage prudent use of antibiotics have been implemented with varying success. Whilst prescriber knowledge and skills are important, attention to behavioural and social aspects in prescribing appear essential to sustain any improvement initiatives. Serious games and gamification have been successfully introduced in other settings to maintain clinicians’ engagement with desired behaviours.

In collaboration with clinicians from Imperial College Healthcare NHS Trust and a commercial software company, the NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial has developed 'On call: antibiotics', an electronic prescribing game to support and encourage the prudent use of antimicrobials in acute care. 'On call: antibiotics' allows doctors, nurses and pharmacists to manage a series of virtual patients attending a simulated hospital. Racing against the clock and the increasing workload, players receive information about the symptoms experienced by patients and have to diagnose and manage the cases. To be successful, players have to make optimal use of antibiotics and antibiotic prescribing behaviours.

The game provides immediate feedback on players’ performance and decisions, considering clinical accuracy and the impact on other professionals and the wider hospital environment. To sustain the focus on the game, elements such as timers, scores and leaderboards, together with increasing case difficulty are used. Delayed consequences of some prescribing decisions are made explicit for the players; for example, using broad-spectrum antibiotics too frequently will lead to multiple virtual patients attending with antibiotic-associated diarrhoea, or prolonged use of IV antibiotics will result in cannula-site infection cases.

Read more about the development of the ‘On Call: Antibiotics’ game in our published paperThe game is available as a downloadable exe (for Windows) and APK (for Android) from the button at the top. 


  • 2018: Selected as Innovation Showcase, World Innovation Summit for Health, Qatar
  • 2016: Finalist, Health category, Gamification World Congress, Spain
  • 2014: Showcased in the Games for Health 2014, The Netherlands

For further information on the game, please contact Dr Enrique Castro-Sánchez at e.castro-sanchez@imperial.ac.uk