Antimicrobial Prescribing in the Telehealth Setting: Framework for Stewardship During a Period of Rapid Acceleration Within Primary Care.

Antibiotic resistance is a global public health threat. The use of telehealth in primary care presents unique barriers to antimicrobial stewardship, including limited physical examination and changes to the patient-provider relationship. Since the coronavirus disease 2019 (COVID-19) pandemic, there is a need to identify novel antimicrobial stewardship strategies with an explosion in the use of telehealth within primary care. Our review proposes a tailored, sustainable approach to antimicrobial prescribing in the telehealth setting based on the Centers for Disease Control and Prevention's Core Elements of Outpatient Antibiotic Stewardship: commitment, action for policy and practice; tracking and reporting; and education and expertise. The rapid growth of telehealth for all types of primary care visits (not just antibiotic use) is outpacing knowledge associated with strategies for antimicrobial stewardship. Improving antibiotic use within primary care settings is critical as telehealth will remain a priority whether the COVID-19 pandemic recedes, particularly within patient populations with limited access to healthcare.

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Déclaration de conflit d'intérêts

Potential conflicts of interest. K. L. L. has received research funding from Merck, Pfizer, Shionogi, Paratek, and Entasis; grants or contracts unrelated to this work from the National Institutes of Health (NIH) and HSR&D Merit Award; and consulting fees from Paratek Pharmaceuticals and Ferring Pharmaceuticals. K. L. L. has also served as a committee member for the NIH and Antibacterial Resistance Leadership Group Duke Clinical Research Institute, and as a Director of Pharmacology Core for the Rhode Island NIH Centers of Biomedical Research, Excellence Center for Antimicrobial Resistance and Therapeutic Discovery. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.