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按需使用抗生素:异步远程医疗的进展要求加强抗生素监测。

Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance.

作者信息

O'Toole Rebecca, Martinez Kathryn A, Rothberg Michael B, Diiorio Gillian, Stenehjem Edward A, Ward Kristina E, LaPlante Kerry L

机构信息

College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA.

Center for Value-Based Care Research, Cleveland Clinic, Ohio, USA.

出版信息

Clin Infect Dis. 2024 Feb 17;78(2):308-311. doi: 10.1093/cid/ciad472.

Abstract

The rapid growth of telehealth services has brought about direct-to-consumer telemedicine platforms, enabling patients to request antibiotics online without a virtual or face-to-face consultation. While telemedicine aims to enhance accessibility, this trend raises significant concerns regarding appropriate antimicrobial use and patient safety. In this viewpoint, we share our first-hand experience with 2 direct-to-consumer platforms, where we intentionally sought inappropriate antibiotic prescriptions for nonspecific symptoms strongly indicative of a viral upper respiratory infection. Despite the lack of clear necessity, requested antibiotic prescriptions were readily transmitted to our local pharmacy following a simple monetary transaction. The effortless acquisition of patient-selected antibiotics online, devoid of personal interactions or consultations, underscores the urgent imperative for intensified antimicrobial stewardship initiatives led by state and national public health organizations in telehealth settings. By augmenting oversight and regulation, we can ensure the responsible and judicious use of antibiotics, safeguard patient well-being, and preserve the efficacy of these vital medications.

摘要

远程医疗服务的迅速发展催生了直接面向消费者的远程医疗平台,使患者无需进行虚拟或面对面咨询就能在线请求开具抗生素。虽然远程医疗旨在提高可及性,但这种趋势引发了人们对合理使用抗菌药物和患者安全的重大担忧。在这一观点中,我们分享了在两个直接面向消费者的平台上的第一手经验,在这些平台上,我们故意为强烈提示病毒性上呼吸道感染的非特异性症状寻求不适当的抗生素处方。尽管缺乏明确的必要性,但在进行简单的金钱交易后,所请求的抗生素处方很容易就被发送到了我们当地的药房。在没有人际互动或咨询的情况下,患者能够轻松地在网上获取自行选择的抗生素,这凸显了州和国家公共卫生组织在远程医疗环境中加强抗菌药物管理举措的紧迫必要性。通过加强监督和监管,我们可以确保抗生素的合理和审慎使用,保障患者的健康,并维护这些重要药物的疗效。

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