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Prescription of antibiotics by telephone or e-consultation at Dr.Dropin (2022)

As a general rule, doctors should not prescribe antibiotics without conducting clinical and possibly additional examinations.

National professional guidelines for the use of antibiotics in the primary health care service also apply to e-consultations / telephone consultations. In most infections where it may be relevant to treat with antibiotics, clinical examination and any additional examinations according to the guideline will be necessary to determine whether there is an indication for antibiotic treatment. This applies to all respiratory infections and most other infections.

  • E-consultation is a doctor's appointment that is conducted online using audio, video or text conversation.

For conditions where the guideline states that the indication for antibiotics does not depend on findings from a clinical and / or supplementary examination, it may be relevant to prescribe antibiotics via telephone or e-consultation. The following factors are emphasized to ensure that the condition is treated in a professionally sound manner:

  • Typical presentation of the condition
  • Good image reproduction (for visually presenting conditions)
  • Knowledge of the patient (chronic diseases, regular medications, allergies, drug compliance, previous episodes with the same condition, risk of complications, etc.)
  • Opportunity to follow up the condition
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Conditions where one is not dependent on clinical findings

For tilstander der retningslinjen angir at indikasjon for antibiotika ikke avhenger av funn ved klinisk og/eller supplerende undersøkelse, kan det være aktuelt å skrive ut antibiotika via telefon- eller e-konsultasjon. Følgende forhold vektlegges for å sikre at tilstanden behandles på en faglig forsvarlig måte:

  • Typisk presentasjon av tilstanden
  • God billedgjengivelse (for tilstander som presenterer seg visuelt)
  • Kjennskap til pasienten (kroniske sykdommer, faste medisiner, allergier, medikament-etterlevelse, tidligere episoder med samme tilstand, risiko for komplikasjoner etc.)
  • Mulighet for å følge opp tilstanden

Digital antibiotic prescription

E-consultations are a new phenomenon, and there is little research on the safety and efficacy of managing infectious diseases without a clinical examination, and whether inappropriate antibiotic use occurs more frequently in e-consultations than in regular consultations.

Without a clinical examination, it will in most cases not be possible to determine whether there is an indication for antibiotics. It is therefore recommended that antibiotics are generally not prescribed by e-consultation. This is in line with the Swedish program council STRAMA. STRAMA has prepared quality indicators for digital consultations. Prescribing antibiotics for digital consultations is not recommended for all common conditions of infection in general practice, with a few exceptions and under certain conditions.

Read more about video doctor appointment hereRead more about self-service here

Source: Helsedirektoratet
https://www.helsedirektoratet.no/retningslinjer/antibiotika-i-primaerhelsetjenesten/antibiotikaforskrivning-ved-telefon-eller-e-konsultasjon#antibiotikaforskrivning-ved-telefon-eller-e-konsultasjon-praktisk