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Pediatric Telemedicine Risks Over Prescribing of Antibiotics


Children with acute respiratory infections were prescribed antibiotics more often during direct-to-consumer (pediatric telemedicine) visits than during in-person medical care appointments or urgent care visits, in keeping with UPMC Children’s Hospital of Pittsburgh research reported today in Pediatrics.

“In recent years, the employment of telemedicine for acute, medical care concerns has increased among children,” said lead author Kristin Ray, M.D., M.S., pediatrician, Division of General Academic Pediatrics, UPMC Children’s Hospital. “We know little about the care children receive during these direct-to-consumer telemedicine visits, which occur with doctors outside of the child’s usual pediatric office.”

Research Results

The researchers examined an outsized, national health plan database that covers over 4 million children within us annually and contracts with a direct-to-consumer telemedicine vendor. The team compared antibiotic prescribing for acute respiratory infections among pediatric direct-to-consumer telemedicine visits compared to visits at medical care offices and urgent care centers which were matched by age, state, diagnosis, and other variables.

The analysis revealed that children received antibiotic prescriptions during 52% of telemedicine visits, compared with 42% of urgent care and 31% of medical care provider visits. Compared to medical care and urgent care visits, the antibiotics received at telemedicine visits also were less likely to be in step with clinical guidelines. the employment of antibiotics that don’t seem to be necessary or that is broader than necessary may lead to side effects and contribute to antibiotic resistance.

Should we trust pediatric telemedicine?

“Insurers are increasingly offering telemedicine — with 96% of huge business insurance plans now offering coverage — and as a result, lots of children now have access, and our prior work found that use is rapidly increasing,” added Ray, also a professor of pediatrics, University of Pittsburgh School of medication.

“As a general pediatrician, I’m inquisitive about making care easier and fewer burdensome for families, and that I think there are many technological innovations that aim to try to do this, but I believe it is also important to create sure the standard of the care that children receive remains high,” Ray said.

According to Ray, these differences in antibiotic prescribing found during this analysis were much larger than the differences found in similar analyses of direct-to-consumer telemedicine visits by adults. This underscores the necessity for pediatric-specific analyses of health system innovations to create sure we understand the impact of the latest methods of health supply not only for adults but also specifically for kids.

University of Pittsburgh. (2019, April 8). Pediatric telemedicine visits may increase antibiotic overprescribing. ScienceDaily. Retrieved November 8, 2019 from 


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