Telehealth in pediatric primary care supports judicious antibiotic prescribing

According to a study presented at the Pediatric Academic Societies (PAS) 2025 Meeting, held April 24–28 in Honolulu, children treated with primary care telehealth visits were less likely to receive antibiotics for acute respiratory tract infections than those examined in person.

While providers prescribed 12% fewer antibiotics during initial primary care telehealth visits compared to in-person appointments, both settings had similarly high rates of following established guidelines, according to researchers. In the two weeks after the initial visit, children who had a telehealth visit received no more antibiotics than those who had an in-person visit.

“These findings show that when used in the context of a primary care practice, telehealth can allow primary care physicians to provide treatment that aligns with guidelines,” said Samuel Wittman, MS, research data analyst at the University of Pittsburgh and presenting author.

“Integrating telehealth into pediatric primary care allows pediatricians more options for getting children connected to the right care at the right time, especially for families with time, transportation, or financial barriers.”

Previous studies found potential overprescription of respiratory infection treatment during telehealth visits in virtual urgent care settings, the authors note, leading them to study its use in the primary care medical home specifically.

The findings show potential value—and allay fears—about integrating telehealth within primary care. Appropriate prescribing ensures quality antibiotic management and reduces the risk of contributing to antimicrobial resistance, the authors said.

The national study analyzed more than 540,000 pediatric visits for acute respiratory tract infections across 843 U.S. pediatric and family primary care sites.