Antimicrobial resistance (AMR) is increasing worldwide, disproportionately affecting low- and middle-income countries (LMICs). In these settings, limited diagnostic capacity, shortages of microbiologists, and non-standardised antimicrobial susceptibility testing (AST) practices exacerbate AMR-related mortality and fuel the global spread of resistant organisms.
In 2024, the International Centre for Antimicrobial Resistance Solutions (ICARS) supported the EUCAST Development Laboratory in conducting an independent evaluation of the free Antibiogo app, developed by Médecins Sans Frontières (MSF). The app aims to provide access to accurate AST interpretation in settings where microbiologists are not available. The project set out to test the reliability of Antibiogo under standardised conditions following its broader testing across various LMIC settings.
About Antibiogo
Antibiogo is a free-of-charge smartphone application that allows laboratory technicians to photograph antimicrobial susceptibility testing (AST) agar plates and upload the images via the app. Firstly, the app uses image recognition software combined with artificial intelligence AI to identify the antibiotic disks that have been applied to the plate. If the software does not automatically detect them, technicians can enter the information manually.
Secondly, the app provides a semi-automated measurement of inhibition zone diameters (IZD), which the technician can adjust (if needed) and approve. Once the app has obtained this information, the data is sent to the second software component: the expert system. The expert system applies a set of preset expert guidance based on the latest CLSI/EUCAST breakpoints and interpretive rules to translate IZDs into susceptibility categories (susceptible: S; susceptible, increased exposure: I; resistant: R). Results are then generated with interpretive comments to the lab tech and clinicians.
Key results from the ICARS-supported independent evaluation
The independent evaluation indicated that Antibiogo is a highly accurate, easy-to-use tool with high potential for supporting non-expert laboratory staff in resource-limited settings in producing reliable AST results.
For detailed results, read the project summary.
What Antibiogo could mean for the mitigation of AMR
Accurate AST interpretation is essential to ensure that doctors can appropriately prescribe antibiotics. However, in the absence of trained microbiologists, misinterpretation may lead to inappropriate antibiotic use, a breakdown of trust between laboratories and clinicians, and an increased risk of AMR dissemination. As a free-of-charge, easy-to-use diagnostic tool, Antibiogo can ensure more equitable access to high-quality AST interpretation, supporting the appropriate use of antibiotics, thereby slowing the emergence and spread of AMR.
After being adopted by all MSF laboratories in 2024, the tool was integrated by local health authorities in 2025 in Burkina Faso, Comoros, Guinea, Liberia, Mali, the Central African Republic, the Democratic Republic of the Congo, Niger and Benin.
In September 2025, Antibiogo reached a major milestone by obtaining ISO 13485 certification, an international quality management standard for medical device manufacturers. This certification demonstrates that Antibiogo meets the highest international regulatory requirements for safety and reliability, showing that a digital health tool can be both high-quality and accessible. Additionally, The WHO Compendium 2024 highlights Antibiogo in the newly commercialised category for its capacity to improve diagnostic access and data quality.
Next steps
MSF aims to continue scaling up Antibiogo, rolling it out in countries including Yemen, Iraq, Syria, Ivory Coast, Mauritania and others.
The Antibiogo app presents significant possibilities for ICARS-supported projects, including as a tool to strengthen capacity in under-staffed and under-resourced contexts, and to promote antimicrobial stewardship through improved diagnostic accuracy. Antibiogo could also be integrated with the ICARS-supported Centre of Excellence project, which supports human and veterinary laboratories across Africa in all aspects of AST. Training could be provided by regional experts via remote consultations, ensuring that laboratory staff gain practical, hands-on experience in the effective and appropriate use of the tool.
