Geographic variability of antibiotic prescribing for acute respiratory tract infections within a direct-to-consumer telemedicine practice.

In this retrospective cohort study of patients presenting to a national direct-to-consumer medical practice, we found that provider geographic location is a stronger driver of antibiotic prescribing than patient location. Physicians in the Northeast and South are significantly more likely than physicians in the West to prescribe antibiotics for upper respiratory infection and bronchitis.

What we now know about the COVID-19 Delta variant

Experts answer pediatricians' and parents' top questions about this COVID-19 strain's impact on children. Since March 2021, when it was first encountered in the United States, the B.1.617.2 (Delta) variant of SARSCoV-2 has spread rapidly;as of November, Delta represents the predominant strain causing COVID-19 in the United States.1 How does this variant differ from others, and how does it affect pediatric patients? [...]known as breakthrough infections, these cases have been more frequently observed since the Delta variant surge. Because these individuals are contagious, it is important to follow isolation precautions.13 Thankfully, vaccination effectively reduces the overall risk of infection with COVID-19 by 6-fold.5 Does the Delta variant cause more severe disease In children? Findings published in the New England Journal of Medicine showed that one of the current available vaccines (BNT162b2;Pfizer/BioNTech) has slightly lower effectiveness against the Delta variant compared with the Alpha variant (88% vs 93.7%, respectively).7 A subsequent report by the Centers for Disease Control and Prevention (CDC) stated that the Moderna vaccine's efficacy was 92% in adults during the Delta variant surge.8 Findings of a study evaluating the trends in COVID-19-related emergency department (ED) visits and hospitalizations since the Delta variant surge showed that ED visits and hospitalizations were more than 3 times higher in US states with the lowest vaccination coverage (< 50%) compared with those with the highest coverage (> 70%). [...]this article was drafted, the US Food and Drug Administration had recently approved the Pfizer/BioNTech vaccine for emergency use in children aged 5 to 11 years old and is currently being evaluated by the CDC Advisory Committee on Immunization Practices (ACIP) for further recommendations to the general public.9 Our health authorities continue to recommend masking and social distancing in addition to vaccination.