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Acute respiratory tract infections (ARTIs) are common diagnoses among pediatric patients, and a recent study of 449,630 pediatric ARTI visits found antibiotics were prescribed less often during telemedicine visits than in-person visits, as published in JAMA Network Open. Antibiotic prescriptions were written during 46.8% (95% confidence interval [CI], 45.1%-48.4%) of primary care in-person visits vs 34.6% (95% CI, 27.0%-42.3%) of primary care telemedicine visits with a difference of −12.1 (95% CI, −19.3 to −5.0) percentage points. The good news is that antibiotic management in alignment with guidelines was similar between the groups (85.5% for telemedicine vs 86.2% for in-person care). Telemedicine patients were more likely to receive viral diagnoses (66.9% vs 55.6%). Additionally, telemedicine visits were associated with fewer acute otitis media diagnoses (difference of −15.3 percentage points) and more sinusitis diagnoses (difference of 9.9 percentage points). The study examined visits between January 1 and December 31, 2023, across 694 U.S. pediatric and family medicine primary care clinics.
Later outcomes: Authors note follow-up visits and subsequent antibiotic prescribing within 14 days did not differ significantly by visit type, suggesting lower antibiotic use in telemedicine did not lead to missed infections or delayed treatment.