# UpToDate vs Firstline

The clearest difference is review sentiment: Firstline at 89% against UpToDate's 28%. Firstline also leads on rating (4.9 vs 3.6) and monetization model (free vs subscription). UpToDate's advantage is chart position (#207 vs unranked). On price, ratings volume, ads and in-app purchases there is nothing between them.

Both are free to download. Neither carries in-app purchases, so what you see is what you pay.

Firstline holds the better App Store score, 4.9 against 3.6. Both are backed by a comparable volume of ratings — 583 and 645 respectively. Written reviews point the same way: 28% of UpToDate's written reviews are positive against 89% of Firstline's.

UpToDate ships an update every 5 weeks, Firstline every 2 weeks. The most recent releases landed on October 22, 2026 and October 21, 2026 respectively.

## The numbers

| Metric | UpToDate | Firstline |
| --- | --- | --- |
| Price | Free | Free |
| Rating | [3.6 (583 ratings)](https://appshunter.io/ios/app/uptodate/id334265345/reviews) | **[4.9 (645 ratings)](https://appshunter.io/ios/app/firstline-clinical-decisions/id921339941/reviews)** |
| Number of ratings | 583 | **645** |
| Positive reviews | 28.2% of reviews | **89.5% of reviews** |
| In-app purchases | No | No |
| Ads | No | No |
| Update frequency | Every 5 weeks | **Every 2 weeks** |
| Monetization | Subscription | **Free** |
| Best chart rank | **#207** | — |
| Size | 56 MB | 3 MB |
| Requires iOS | 18.0 | **16.0** |
| Devices | iPhone, iPad | iPhone, iPad |
| Age rating | 17+ | 17+ |
| Developer | [UpToDate, Inc.](https://appshunter.io/developer/334265348) | [Spectrum Mobile Health Inc.](https://appshunter.io/developer/1072846527) |

## What reviewers say

### UpToDate

[App page](https://appshunter.io/ios/app/uptodate/id334265345)

**Currently charting:** #207 Top Free · Medical (US App Store)

This clinical decision support tool provides healthcare professionals with evidence-based guidance to improve patient care. It features AI-powered conversational answers, continuously updated medical content, and tools for drug reference, calculations, and patient education.

**Highlights:** Expert AI conversational guidance, Gold standard clinical content, Practice-changing updates, Patient education materials, Drug reference and interactions, Clinical calculators, Kidney dosing guidance

**Features:** Vision Pro support

**In-app purchases:** none

**What reviewers like**

- 💎 Invaluable medical resource
- 🚀 Quick and easy to use
- 🔍 Comprehensive and up-to-date content

**What reviewers complain about**

- 🐛 Frequent crashes and freezing issues
- 🔌 Unreliable offline functionality
- 💰 Expensive subscription cost

**Reported bugs**

- Inability to download offline content
- Constant need to re-authenticate
- Incompatibility with recent iOS updates

**Requested features**

- Highlight and annotate content
- Improved institutional login support
- Dark mode and font size options


### Firstline

[App page](https://appshunter.io/ios/app/firstline-clinical-decisions/id921339941)

Provides healthcare professionals with interactive, point-of-care guidance for optimal patient treatment. Access customizable protocols, antimicrobial stewardship, and infection control information. Updates are rapid and it functions offline.

**Highlights:** Antimicrobial Stewardship guidelines, Infection Prevention & Control protocols, Customizable for healthcare organizations, Antimicrobial formulary information, Pathogen and antibiogram data, Offline functionality

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases:** none

**What reviewers like**

- 👍 Easy to use and intuitive navigation
- 🎨 Beautiful and visually pleasing design
- 📚 Excellent reference resource for medical professionals
- ⚡ Quick and convenient point-of-care tool
- 🏥 Highly useful for clinical decision-making

**What reviewers complain about**

- 🐛 App fails to load or progress past loading screen
- 🐛 Frequent crashes after updates
- ⚠️ Stability issues requiring reinstallation
- ❌ Unresponsive membership request process

**Reported bugs**

- App will not progress past loading screen
- App crashes constantly on startup after updates
- Requires uninstall and reinstall to resolve crashes
- Crashes return after a few hours or days

**Requested features**

- Treatment duration guidelines for pathogens
- Regional data for additional areas (e.g., Southern Ontario/Hamilton/Toronto)
- More specific treatment duration information


## Frequently asked questions

### Is UpToDate free?

UpToDate is free to download, with no in-app purchases.

### Is Firstline free?

Firstline is free to download, with no in-app purchases.

### Which has better reviews, UpToDate or Firstline?

Firstline is rated higher. UpToDate averages 3.6 out of 5 from 583 ratings, while Firstline averages 4.9 from 645 ratings.

### Do UpToDate or Firstline have ads?

Neither UpToDate nor Firstline shows ads.

### Which is updated more often, UpToDate or Firstline?

UpToDate ships an update every 5 weeks, and Firstline every 2 weeks. Most recently, UpToDate was updated on October 22, 2026 and Firstline on October 21, 2026.

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*Compared by [AppsHunter](https://appshunter.io/) from daily US App Store data. Review summaries are generated from verbatim App Store reviews.*