The disastrous invasion of antibiotics around the world is taking on even more worrisome contours: in the U.S. they even prescribe them with virtual visits. Better not to import this phenomenon to Italy, we say: but why do we need to be so careful?
Overuse and inappropriate use of antibiotics have contributed to the emergence of increasingly resistant bacteria. Exaggerated prescribing by physicians and the use of products on livestock farms are among the major culprits for this phenomenon. And in the United States the situation is getting worse, because of doctors who are prescribing antibiotics to children through visits made with smartphones, all online and probably all at random.
A study published in the journal ‘Pediatrics‘ and funded by the NIH (National Health Institute)National Institute of Health described the phenomenon alarmingly. More than half of the children seeking care online for acute respiratory infections (sinusitis, bronchiolitis) received antibiotics, a solution less used by children visited in person. Telemedicine and its flaws are blatantly visible in this case.
In fact, it is often difficult for doctors to distinguish between a bacterial and a viral infection, with the latter not requiring the use of antibiotics; one can only imagine how it is possible to zero in on the right treatment with an online ‘visit’. As many as 2 million people in the United States have been affected by antibiotic-resistant bacteria in the past year, a symptom of overuse of these drugs.
The researchers examined in the study as many as 4604 telemedicine visits, 38408 emergency room visits and 485201 pediatric visits, excluding all cases limit such as urinary tract infections and other non-bacterial disorders or viral. This is a broad spectrum of cases.
While in Italy personal contact with the doctor is a basic prerogative, thanks in part to an accessible health care system, in the United States the medical field is often a matter of saving money. Virtual visits, or telemedicine, represent a business with ample room to maneuver. Leading Teladoc, which opened the MinuteClinic site in August, allows patients over two years old to see the doctor with an app on their smartphone, for only $60. Other companies are following suit.
Why do American citizens love this kind of business? For laziness: telemedicine advertisements sell the time and effort saved in moving to see the doctor in person. But all associations, particularly pediatric associations, are trying to discourage parents from using this type of treatment, particularly when children suffer acute symptoms
Beware of the antibiotic (especially if prescribed online)!
In the United States, a study published in the journal ‘Pediatrics’ and funded by the NIH (National Health Institute) examined a Very high number of pediatric visits (specifically 485201 visits outpatient, 38408 ER visits, 4604 visits made online) to verify The percentage of antibiotic prescriptions for acute respiratory infections (such as sinusitis and bronchiolitis). Well: it turned out that, unlike the other two groups, more than half of the children visited online were given prescribed antibiotics.
This opens to two considerations:
- The first, already well known but unfortunately rehashed, related to the inappropriate and excessive use of antibiotics (both through exaggerated prescribing by doctors and their use in livestock farms), which has contributed to the emergence of increasingly resistant bacteria (it is estimated that as many as two million people in the United States alone have been affected by resistant bacteria in the past year)
- The second refers to the practice of online visits, via smartphones, which make it even more difficult for physicians to distinguish between a bacterial or viral infection, precisely because all those complex elements fundamental to clinical observation are missed
Certainly an online visit is cheaper and more convenient, but fortunately our health care system still has population health as its goal. and not solely and exclusively savings and convenience.