Abstract：
BACKGROUND: Antibiotic overprescribing for acute respiratory tract infections (ARTIs) commonly occurs and can lead to higher medical costs, antibiotic resistance, and health complications. Inappropriate prescribing of antibiotics for ARTIs has been shown to occur more frequently in urgent care than other outpatient settings. It is not clear whether antibiotic overprescribing varies between virtual and in-person urgent care.
OBJECTIVE: Summarize published primary scientific literature on antibiotic prescribing patterns for ARTIs among adults in virtual urgent care settings.
METHODS: We conducted a systematic review to compare antibiotic prescribing for ARTIs between virtual and in-person urgent care. Our review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We assessed risk of bias using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) assessment tool. We summarized study results from seven included retrospective cohort studies.
CONCLUSIONS: Antibiotic prescribing frequency may be similar between virtual urgent care and in-person care for adult patients treated for ARTIs. However, variability existed in intervention characteristics, settings, and outcome measures. Additional studies are needed to better understand the conditions in which virtual care may be most effective.
CONCLUSIONS: Evidence suggests that giving providers direct access to evidence-based guidelines and electronic health records within the virtual visit may support diagnosis and management. Furthermore, practices that use telemedicine platforms for virtual urgent care visits should consider how to potentially improve diagnosis and management of conditions through the use of home-based point-of-care testing or accessory \"e-tools.\"
OBJECTIVE: Summarize published primary scientific literature on antibiotic prescribing patterns for ARTIs among adults in virtual urgent care settings.
METHODS: We conducted a systematic review to compare antibiotic prescribing for ARTIs between virtual and in-person urgent care. Our review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We assessed risk of bias using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) assessment tool. We summarized study results from seven included retrospective cohort studies.
CONCLUSIONS: Antibiotic prescribing frequency may be similar between virtual urgent care and in-person care for adult patients treated for ARTIs. However, variability existed in intervention characteristics, settings, and outcome measures. Additional studies are needed to better understand the conditions in which virtual care may be most effective.
CONCLUSIONS: Evidence suggests that giving providers direct access to evidence-based guidelines and electronic health records within the virtual visit may support diagnosis and management. Furthermore, practices that use telemedicine platforms for virtual urgent care visits should consider how to potentially improve diagnosis and management of conditions through the use of home-based point-of-care testing or accessory \"e-tools.\"
摘要：
背景：急性呼吸道感染（ARTI）的抗生素处方过多通常会发生，并可能导致更高的医疗费用，抗生素耐药性,健康并发症。与其他门诊患者相比，在紧急护理中，对ARTI的抗生素处方不当的发生率更高。目前尚不清楚抗生素的过度处方是否在虚拟和当面紧急护理之间有所不同。
目的：总结已发表的关于虚拟紧急护理环境中成人ARTI抗生素处方模式的主要科学文献。
方法：我们进行了一项系统评价，以比较虚拟和当面紧急护理之间ARTI的抗生素处方。我们的审查以系统审查和荟萃分析（PRISMA）清单的首选报告项目为指导。我们使用非随机干预研究中的偏倚风险（ROBINS-I）评估工具评估偏倚风险。我们总结了7项纳入的回顾性队列研究的研究结果。
结论：对于接受ARTI治疗的成年患者，虚拟紧急护理和现场护理之间的抗生素处方频率可能相似。然而,干预特征存在变异性，设置，和结果措施。需要更多的研究来更好地了解虚拟护理可能最有效的条件。
结论：证据表明，在虚拟访问中，让提供者直接访问循证指南和电子健康记录可以支持诊断和管理。此外，使用远程医疗平台进行虚拟紧急护理访问的实践应考虑如何通过使用基于家庭的现场护理测试或辅助“电子工具”来潜在地改善疾病的诊断和管理。\"
目的：总结已发表的关于虚拟紧急护理环境中成人ARTI抗生素处方模式的主要科学文献。
方法：我们进行了一项系统评价，以比较虚拟和当面紧急护理之间ARTI的抗生素处方。我们的审查以系统审查和荟萃分析（PRISMA）清单的首选报告项目为指导。我们使用非随机干预研究中的偏倚风险（ROBINS-I）评估工具评估偏倚风险。我们总结了7项纳入的回顾性队列研究的研究结果。
结论：对于接受ARTI治疗的成年患者，虚拟紧急护理和现场护理之间的抗生素处方频率可能相似。然而,干预特征存在变异性，设置，和结果措施。需要更多的研究来更好地了解虚拟护理可能最有效的条件。
结论：证据表明，在虚拟访问中，让提供者直接访问循证指南和电子健康记录可以支持诊断和管理。此外，使用远程医疗平台进行虚拟紧急护理访问的实践应考虑如何通过使用基于家庭的现场护理测试或辅助“电子工具”来潜在地改善疾病的诊断和管理。\"
