Close that app: Online doctor’s visits linked to antibiotic overuse, warn researchers
By Edsel Cook // Sep 01, 2019

Telemedicine might seem convenient compared to visiting the clinic in person. However, an online healthcare practitioner is more likely to prescribe unnecessary pharmaceutical drugs to the patient, researchers warn. This over-prescription not only makes antibiotic overuse more likely, but also increases the risk of superbugs with antibiotic resistance.


An increasing number of healthcare providers and specialists offer their services through online portals or smartphone apps. They set appointments with their patients, write prescriptions, keep in touch with their patients, and send the results of laboratory tests through online methods.

However, telemedicine suffers from many drawbacks and problems. Distance is the most glaring issue – the healthcare provider and his patient are not in the same room. They may not even see eye-to-eye or face-to-face on the screen.

A recent study by researchers from the National Institutes of Health (NIH) found that online appointments might contribute to the growing problem of antibiotic overuse in the United States. In turn, excessive prescription and use of antibiotics may make it more likely for antibiotic-resistant superbugs to appear. (Related: Electric bandages? Researchers say they heal wounds better, faster than antibiotics.)

Online healthcare services

The NIH researchers looked at the billing data of telemedicine visits, urgent care visits, and primary care visits for child patients with acute respiratory infections. They compared antibiotic-prescribing practices between each group.

They reported that child patients who sought online healthcare for respiratory infections received a prescription of antibiotic drugs around 52 percent of the time. Meanwhile, participants who visited their primary healthcare provider in person only got prescribed such drugs 31 percent of the time. Finally, children taken to an urgent care clinic were given an antibiotic prescription 42 percent of the time.

Online healthcare providers cannot conduct the physical exams and tests required to tell apart bacterial infections from viral infections. If they prescribe antibiotics for a viral infection, the unnecessary drugs end up increasing the risk of bacteria developing antibiotic resistance.

“Many infections are viral, and these infections don't get treated with antibiotics. It may be difficult for a virtual doctor visit to really understand if there is a bacterial infection or not because it is harder to examine the child through this method of evaluation,” explained integrative medicine practitioner Dr. Marvin Singh of the Mind Body Green Collective.

Overuse of antibiotics harms the gut microbiome – kids especially at risk

In addition to spurring the rise of superbugs with antibiotic resistance, the overuse of antibiotics might harm the gut microbiome of children. Antibiotics kill both good bacteria and bad bacteria without discrimination.

Antibiotics might mean the difference between life and death. Thus, healthcare practitioners should avoid prescribing them carelessly.

They need to exert particular care with child patients. The gut microbiome of a child develops alongside its host. Disrupting the growth of immature gut microbiota might lead to severe effects in the future.

“For example, taking a single course of an antibiotic for a week has been shown to put certain species of bacteria in our gut into dormancy or hibernation for two years,” explained Singh. “So we want to make sure that we use antibiotics for the right cause and not preventively or just in case.”

Babies and toddlers face the highest risk concerning the use of unnecessary antibiotics. The most critical development for the gut microbiome takes place during the first two to three years of life. Any disruptions might cause repercussions for the rest of the child's life.

In summary, avoid taking shortcuts when it comes to health. To reduce the risk of potentially unnecessary antibiotics, visit the healthcare clinic in person as much as possible.

Sources include:

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