AUDIO: Telemedicine could lead to overprescribing antibiotics to children

Children with cold symptoms seen via telemedicine visits were far more likely to be prescribed antibiotics than those who went to a doctor’s office or clinic, according to a new study.

Author Dr. John Poothullil said even the percentage of antibiotics prescribed in person at the doctors office is too much, because there’s no way to tell if a child will respond to an antibiotic. He said usually a child’s fever and sore throat is caused by a virus, not bacteria, which is why flus and colds don’t respond to them.

“Even under ordinary circumstances in the doctor’s office, the doctors feel compelled to do something because the parents are anxious, the child has fever, what is the best thing to do,” said Poothullil. “The doctor has to make a decision right then and there and the easiest thing is to prescribe an antibiotic so the parents feel good, the doctor feels good.”

He said when it comes to telemedicine visits, the doctor prescribes antibiotics, rather than be wrong. But, antibiotics can often do more harm.

“We have beneficial bacteria in the body of the child that can be damaged by the antibiotic. Even more important, frequent use of unneeded antibiotic can cause resistance in the germ that the child might already have,” said Poothullil. “And then that bacteria can spread from person to person. And, we have now many bacteria that have become resistant to commonly used antibiotics.”

He said it’s wishful thinking on the doctor’s part, that antibiotics will help and everyone is in a rush. But, in the long term we all pay a price for it.

Baylor College of Medicine Assistant Professor of Pediatrics and Texas Children’s Hospital Pediatric Infectious Disease Dr. Claire Bocchini said telemedicine is great for rural areas and mental healthcare, but not optimal for general pediatric care who need to be seen in person by a provider. Diagnosing strep throat is hard to do via telemedicine, especially without swabs or cultures collected.

"We know that more antibiotics when they're not needed leads to a higher risk of these really resistant bacteria in our community," said Bocchini.

She added most children will have several viruses every year which have to run their course--antibiotics don't help. Antibiotics have side effects and should be used only when absolutely necessary for the benefit of the patient and community.

"We're seeing the development of just these superbugs that are resistant to almost all of the usual antibiotics that we have," said Bocchini.

She added it's important that children do not get overprescribed antibiotics.

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