Trends in Telehealth Antibiotic Prescribing for Children Through the COVID-19 Pandemic.

Abstract

Telehealth visits increased significantly during the coronavirus disease 2019 pandemic without consensus on the appropriate scope of telehealth antibiotic prescribing within pediatric primary care. We describe telehealth antibiotic prescribing patterns within our statewide pediatric primary care network during the coronavirus disease 2019 pandemic. In a retrospective observational study of a large statewide pediatric primary care network, we identified and analyzed telehealth and in-person encounters with oral antibiotics prescribed from March 2020 to July 2021. We focused on the top 5 general diagnosis groupings using International Classification of Disease 10 codes. Of the 55 926 encounters with an oral antibiotic prescribed, 12.5% were conducted via telehealth and 87.5% in person. The proportion of telehealth antibiotic encounters varied significantly according to diagnosis category (P <.001): ear (30.8%), skin and subcutaneous (21.8%), respiratory (18.8%), genitourinary (6.3%), and Lyme disease infections (3.8%). The proportion of telehealth antibiotic encounters for all diagnosis categories peaked in spring of 2020. The greatest proportion of telehealth antibiotic prescribing during the most recent 4weeks of the analysis were Lyme disease infections (11.7%) and for skin and subcutaneous tissue infections (3.1%). Telehealth continues to be used to prescribe antibiotics even after the initial stage of the pandemic. Clinicians and patients would benefit from clearer guidelines about the appropriate use of antibiotics prescribed during telehealth encounters.