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 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 CDC’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.

中文翻译：

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远程医疗环境中的抗菌药物处方：初级保健快速加速时期的管理框架


抗生素耐药性是全球公共卫生威胁。在初级保健中使用远程医疗对抗菌药物管理提出了独特的障碍，包括有限的体检和患者与提供者关系的变化。自 COVID-19 大流行以来，随着初级保健中远程医疗的使用激增，需要确定新的抗菌药物管理策略。我们的审查提出了一种基于疾病预防控制中心门诊抗生素管理核心要素的远程医疗环境中定制的、可持续的抗菌药物处方方法：政策和实践的承诺、行动；跟踪和报告；以及教育和专业知识。所有类型的初级保健就诊（不仅仅是抗生素使用）的远程医疗的快速增长超过了与抗菌药物管理策略相关的知识。改善初级保健机构内抗生素的使用至关重要，因为无论 COVID-19 大流行是否消退，远程医疗仍将是一个优先事项，特别是在获得医疗保健机会有限的患者群体中。