Clinical Report: Comparing Telemedicine and In-Person Consultations for Antibiotic Treatment in Children with Respiratory Infections

Overview

This study evaluates antibiotic prescribing practices for pediatric acute respiratory tract infections (ARTIs) during telemedicine visits compared to in-person consultations. Findings indicate that telemedicine integrated within primary care may lead to lower rates of antibiotic prescriptions and improved guideline adherence.

Background

Acute respiratory tract infections are a significant cause of pediatric outpatient visits and antibiotic prescriptions, with many being unnecessary. Understanding the effectiveness of telemedicine in managing these conditions is crucial, especially as it can alleviate the burden on families. This study aims to assess the quality of care provided through telemedicine in comparison to traditional in-person visits.

Data Highlights

This study analyzed data from 694 US primary care practices, focusing on antibiotic prescribing and guideline-concordant management for telemedicine versus in-person visits for ARTIs.

Key Findings

• Telemedicine visits showed lower rates of antibiotic prescriptions compared to in-person visits.
• Guideline-concordant care was more frequently observed in telemedicine consultations integrated within primary care.
• Over 50% of visits for ARTIs typically result in antibiotic prescriptions, highlighting the need for careful management.
• Prior studies indicated higher antibiotic prescribing rates in direct-to-consumer telemedicine models.
• Policy changes post-COVID-19 have facilitated the integration of telemedicine in primary care practices.

Clinical Implications

Healthcare providers should consider integrating telemedicine into pediatric care for ARTIs to potentially reduce unnecessary antibiotic prescriptions. Ongoing training and adherence to guidelines are essential to ensure quality care in telemedicine settings.

Conclusion

The findings suggest that telemedicine can be a viable alternative to in-person visits for managing pediatric ARTIs, with potential benefits in reducing antibiotic overprescribing. Further research is needed to confirm these outcomes across diverse practice settings.

References

1. JAMA Network Open, 2023 -- Primary Care Telemedicine as an Antibiotic Stewardship and Environmental Solution
2. Open Forum Infectious Diseases, 2023 -- Evaluating In-person Infectious Disease Care Versus Daily Telemedicine Services at a Community Hospital
3. The Journal of Infectious Diseases, 2023 -- Association of Pediatric Antibiotic Prescriptions with Respiratory Syncytial Virus and Influenza in the United States from 2008 to 2018
4. IDSA Clinical Practice Guideline Update on Group A Streptococcal (GAS) Pharyngitis, 2025
5. CDC, 2025 -- Antibiotic Stewardship in Outpatient Telemedicine
6. Infection — Effect of Pediatric Infectious Disease Consultation on Prompt Transition to Oral Antibiotics for Bone and Joint Infections
7. Antibiotic receipt during primary care telemedicine versus in-person visits for pediatric acute respiratory tract infections, 2023
8. IDSA Clinical Practice Guideline Update on Group A Streptococcal (GAS) Pharyngitis
9. Antibiotic Stewardship in Outpatient Telemedicine | Antibiotic Prescribing and Use | CDC