Telehealth Reduces Antibiotic Use for Pediatric ARTIs in Primary Care: Daily Dose

_{©New Africa/AdobeStock}

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On April 29, 2025, we reported on a national retrospective study presented at the 2025 Pediatric Academic Societies (PAS) Meeting that was designed to compare antibiotic management during telemedicine (TM) and in-person (IP) visits for acute respiratory tract infections (ARTis) among children within heterogenous primary care practices.

The study

Researchers retrospectively assessed 540 607 ARTI episodes that occurred among children at 843 primary care practices in the US in 2023. They excluded any patients who were diagnosed during a well visit or had another illness that might require antibiotics.

Investigators used diagnosis codes to determine whether a TM visit was for an ARTI. For each antibiotic prescription, they assessed whether providers followed guidelines for the type of antibiotic prescribed but did not assess whether the prescription was for the appropriate duration, another important aspect of antimicrobial stewardship. They used a logistical regression model to adjust the results for potential differences in the children who received IP or TM care.

The findings

Results showed that antibiotics were prescribed in 16.3% of TM index visits compared with 46.9% of IP visits (P < .001). Also, TM visits had a lower rate of bacterial diagnoses (13.3% TM vs 44.4% IP, P < .001).

Physicians followed antibiotic prescribing guidelines 90% of the time during TM visits compared with a rate of 85.9% for physicians during IP appointments (P < .001). Researchers also found that although follow-up visits occurred more often after TM encounters, the rate of additional antibiotic prescribing within 14 days of the initial visit did not differ significantly between TM and IP groups (1.9% vs 3.7%, P = .15).

Authors' comments

"Despite concerns about antibiotic prescribing for children via TM with direct-to-consumer virtual-only vendors, we found evidence of judicious antibiotic prescribing for children during TM integrated within primary care practices."

Click here for more details.