Study finds online doctors do not prescribe more antibiotics than other providers

Doctors in virtual online health care contacts are no more likely to prescribe antibiotics for infections than doctors in regular health centers, quite the opposite. This is shown by a new study of doctor's visits in Sörmland during 2020–2021 led from Umeå University, Sweden.

"The results indicate that doctors, regardless of employer, follow current recommendations on prescribing antibiotics," says Andy Wallman, pharmacist and senior lecturer in pharmacy at Umeå University and the study's first author.

The paper is published in the Journal of Medical Internet Research.

In the study, the researchers analyzed all health care contacts in infectious diseases within Region Sörmland from January 2020 to March 2021. A total of 160,000 care visits were included, of which about 124,000 took place at traditional, physical, health centers and 36,000 at online doctors.

Of the care visits, 18,000 led to a diagnosis of infection. Among these patients with infectious disease, 61% received antibiotics for the infection at traditional health centers, but only 26% at online doctors.

However, there were major differences in who sought the different types of health care contacts. Visits to traditional health centers were most common in the age group 60–80 years, while visits to online doctors were highest in the age group 20–30 years.

After adjusting for factors such as age, gender and whether the prescription was issued before or during the COVID pandemic, a difference remained, so that the probability of being prescribed antibiotics when visiting an online doctor could be calculated to be less than half, 0.23–0.39, compared to a physical health center.

"There are several possible explanations for the difference, such as the type and severity of infection you seek a physical health center and an online doctor for. It can also be easier for doctors during a physical visit to determine whether it is really a bacterial infection where antibiotics have an effect," says Andy Wallman.

The study shows that there were also some differences in the types of antibiotics that were prescribed. Both doctors at physical health centers and online doctors followed the national and regional recommendations for antibiotic prescribing, but during visits to traditional health centers, a broader spectrum of antibiotics were prescribed.