April 26, 2025
3 min learn
HONOLULU — New research findings supplied extra promising knowledge for main care-based telehealth.
Researchers right here reported the outcomes of a research of greater than a half-million pediatric encounters for acute respiratory tract an infection, which discovered that physicians offering telehealth providers built-in right into a main care observe have been much more considered of their antibiotic prescribing than physicians who noticed kids within the workplace.
Knowledge derived from Wittman S, et al. Antibiotic receipt throughout main care telemedicine versus in-person visits for pediatric acute respiratory tract infections, 2023. Offered at: Pediatric Tutorial Societies Assembly; April 24-28, 2025; Honolulu.
A research by a few of the identical researchers printed final yr in JAMA Community Open had already allayed some considerations concerning the high quality of antibiotic prescribing out there through main care-based telehealth. Specifically, that research confirmed that kids with acute respiratory tract infections obtained fewer antibiotics and required much less follow-up care when their telehealth go to was performed by a service hooked up to a main care observe vs. a virtual-only direct-to-consumer firm.
Within the new research introduced at PAS 2025, Samuel R. Wittman, MS, a analysis knowledge analyst on the College of Pittsburgh Faculty of Drugs, and colleagues retrospectively assessed greater than 540,000 episodes of bacterial or viral acute respiratory tract an infection that occurred amongst kids at 843 main care practices in america in 2023. They excluded any sufferers who have been identified throughout a nicely go to or had one other sickness that may require antibiotics.
The researchers used prognosis codes to find out whether or not a telemedicine go to was for an acute respiratory tract an infection. For every antibiotic prescription, they assessed whether or not suppliers adopted pointers for the kind of antibiotic prescribed however didn’t assess whether or not the prescription was for the applicable period, one other necessary facet of antimicrobial stewardship.
Analysis has proven that acute respiratory tract infections are a number one explanation for inappropriate antibiotic prescribing, and that inappropriate antibiotic prescriptions not solely promote antimicrobial resistance but additionally enhance adversarial drug occasions.
“Acute respiratory tract an infection visits — which embody diagnoses like ear infections, strep throat, and sinusitis, in addition to viral diagnoses — are a few of the most typical causes for youngsters to obtain antibiotics, which is why it’s necessary to focus antibiotic stewardship on these visits,” Wittman instructed Healio in an electronic mail.
He famous that the CDC added telemedicine-related steering to its Core Parts of Outpatient Antibiotic Stewardship in 2024.
“Our group has been working to name consideration to each the necessity for consideration to antibiotic stewardship in outpatient telehealth and the potential for high-quality antibiotic prescribing in outpatient telehealth,” Wittman mentioned.
The brand new research discovered that antibiotics have been prescribed in round 47% of in-person visits attributed to an acute respiratory tract an infection in contrast with round 16% of telemedicine visits for a similar kind of diseases, Wittman and colleagues reported.
The researchers used a logistical regression mannequin to regulate the outcomes for potential variations within the kids who obtained care in-person or through telehealth and located that physicians offering care through telehealth nonetheless prescribed 12% fewer antibiotics in contrast with physicians who noticed sufferers in-person, in keeping with knowledge introduced on the assembly.
Furthermore, physicians adopted antibiotic prescribing pointers 90% of the time throughout telehealth visits in contrast with a charge of round 86% for physicians throughout in-person appointments, the researchers decided.
“General,” Wittman mentioned, “we discovered that acute respiratory tract an infection visits performed through telemedicine built-in inside pediatric main care had low charges of antibiotic prescribing and excessive charges of guideline concordance.”
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Samuel R. Wittman, MS, might be reached at srw52@pitt.edu.
