Antibiotic Prescribing for Respiratory Tract Infections and Encounter Length
Authors: Kathryn A. Martinez, Michael B. Rothberg
Journal: Annals of Internal Medicine (2019)

Letters16 July 2019Antibiotic Prescribing for Respiratory Tract Infections and Encounter LengthKathryn A. Martinez, PhD, MPH and Michael B. Rothberg, MD, MPHKathryn A. Martinez, PhD, MPHCleveland Clinic Center for Value-Based Care Research, Cleveland, Ohio (K.A.M., M.B.R.)Search for more papers by this author and Michael B. Rothberg, MD, MPHCleveland Clinic Center for Value-Based Care Research, Cleveland, Ohio (K.A.M., M.B.R.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0264 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We found that antibiotic prescribing in direct-to-consumer telemedicine is associated with shorter encounters. Dr. Llor and colleagues question the generalizability of this finding to the outpatient setting and note the high proportion of sinusitis diagnoses in our study relative to most outpatient settings. The genesis of our research question was anecdotal: Physicians in the outpatient setting often note that talking a patient out of an antibiotic takes longer than just prescribing one. Although we agree that there are features of telemedicine that distinguish it from outpatient care, why such factors would distort the relationship between antibiotic prescribing and ...References1. Linder JA, Singer DE, Stafford RS. Association between antibiotic prescribing and visit duration in adults with upper respiratory tract infections. Clin Ther. 2003;25:2419-30. [PMID: 14604741] CrossrefMedlineGoogle Scholar2. Imanpour S, Nwaiwu O, McMaughan DK, et al. Factors associated with antibiotic prescriptions for the viral origin diseases in office-based practices, 2006-2012. JRSM Open. 2017;8:2054270417717668. [PMID: 28811907] doi:10.1177/2054270417717668 CrossrefMedlineGoogle Scholar3. Manne M, Deshpande A, Hu B, et al. Provider variation in antibiotic prescribing and outcomes of respiratory tract infections. South Med J. 2018;111:235-42. [PMID: 29719037] doi:10.14423/SMJ.0000000000000795 CrossrefMedlineGoogle Scholar4. Martinez KA, Rood M, Rothberg MB. Coding bias in respiratory tract infections may obscure inappropriate antibiotic use [Letter]. J Gen Intern Med. 2019;34:806-8. [PMID: 30652274] doi:10.1007/s11606-018-4823-x CrossrefMedlineGoogle Scholar5. Barnett ML, Ray KN, Souza J, et al. Trends in telemedicine use in a large commercially insured population, 2005-2017. JAMA. 2018;320:2147-9. [PMID: 30480716] doi:10.1001/jama.2018.12354 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Cleveland Clinic Center for Value-Based Care Research, Cleveland, Ohio (K.A.M., M.B.R.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2042. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntibiotic Prescribing for Respiratory Tract Infections and Encounter Length: An Observational Study of Telemedicine Kathryn A. Martinez , Mark Rood , Nikhyl Jhangiani , Adrienne Boissy , and Michael B. Rothberg Antibiotic Prescribing for Respiratory Tract Infections and Encounter Length Carl Llor , Marie Boël , Gloria Cordoba , and Lars Bjerrum Metrics Cited byUse of Direct-to-Consumer Telemedicine to Access Mental Health Services 16 July 2019Volume 171, Issue 2Page: 150KeywordsAntibioticsAntimicrobialsConflicts of interestDisclosureMotivationOutpatientsPatientsTelemedicineUpper respiratory tract infectionsYoung adults ePublished: 16 July 2019 Issue Published: 16 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...