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Can telehealth prescribe antibiotics? How we assess and treat you

Name: Can telehealth prescribe antibiotics? How it works | The Health Initiative
Published: 2026-09-30

Can telehealth prescribe antibiotics? Yes, when the video exam points to a bacterial infection. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. When a test helps, such as a strep test or a urine culture, we give you a lab order for a lab near you. If it turns out to be a virus, she explains how to feel better at home.

Can we help by telehealth?YesWe can help by telehealth.

$79Doctor visit

Is it an emergency? Call 911.

Doctor visit: $79 — Book See prices and what each includes

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You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.

If you choose a time less than 24 hours away, it can't be cancelled or changed.

If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.

Is this an emergency?

This is not an emergency service. Call 911 or go to the nearest emergency room if you have:

Trouble breathing, chest pain or blue lips
Swelling of the face, lips or tongue, or hives all over after taking a medicine
High fever with a stiff neck, confusion or being very drowsy
Fever with chills and pain in the back or side (possible kidney infection)
Bloody diarrhea, or severe, frequent diarrhea during or after antibiotics

Call 911

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Warning signs: when to go to the ER

On this page (9)

What are antibiotics, and when can telehealth prescribe them?

Antibiotics are medicines that fight infections caused by bacteria: they kill the bacteria or stop them from growing and multiplying. They treat only certain bacterial infections and do not work on viruses. The CDC gives strep throat, whooping cough and urinary tract infections as examples.

On video, Dr. Diana Nieves Castro, a general practice physician licensed in Puerto Rico with several years of emergency-department experience, reviews your symptoms, history and medicines. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. Some common reasons people ask about antibiotics:

Burning or frequent urination: see UTI.
A sore throat with fever and no cough: see sore throat.
Congestion and facial pain that won't let up: see sinus infection.

The Health Initiative · Telehealth

Request your visit now, from home and without driving. It works on your phone, tablet or computer.

The doctor evaluates you and tells you what you most likely have and what to do.
If appropriate, she prescribes and we send your prescription to your pharmacy.
If needed, she gives you a lab order or a doctor’s note.

Before you request a visit, check the warning signs on this page. If you have any of them, do not wait: call 911 or go to the emergency room. See the warning signs

$79Doctor visit

Request your visit now

Charged when you request · full refund if the clinic can’t see you

Video doctor visits 24/7 — book online and choose your time right away.

For problems that are not emergencies. In an emergency, call 911. The doctor decides at the visit whether a treatment is right for you.

Common antibiotics and what they treat

These are the most-searched antibiotics, such as amoxicillin, azithromycin and doxycycline, and what they are used for according to their FDA labels, the CDC and medical guidelines. This is general information: the doctor decides whether you need an antibiotic and which one, based on your evaluation, your allergies and the medicines you take. Do not choose or start an antibiotic on your own.

Amoxicillin: what it treats. It is a penicillin-type antibiotic. It is used for certain bacterial infections, such as strep throat (the CDC names penicillin or amoxicillin as the first choice), ear and sinus infections, pneumonia and some skin and urinary infections. Amoxicillin-clavulanate (Augmentin) adds an ingredient that protects it from bacteria that break down amoxicillin; its label includes ear, sinus, skin and urinary infections. If you are allergic to penicillin, tell the doctor before anything is prescribed.
Azithromycin: what it treats. It is a macrolide; its 5-day pack is known as the Z-Pak. The CDC lists it among the preferred antibiotics (macrolides) for whooping cough, and it is the drug of choice for babies under 1 month old. Like any antibiotic, it does not help a cold, the flu or most cases of bronchitis, and most sinus infections are viral. The FDA warns it can change the heart's rhythm (QT prolongation), with higher risk if you already have a long QT interval, low potassium or magnesium, a slow heart rate, or take medicines for heart rhythm.
Doxycycline: what it treats. It is a tetracycline. The CDC recommends it as the first-choice treatment for chlamydia; it is also used for acne and rosacea, and the CDC lists it among the antibiotics for leptospirosis. It makes your skin more sensitive to the sun: use sunscreen and covering clothes. It can harm the baby during pregnancy, and in children under 8 it is used only in specific cases (such as Rocky Mountain spotted fever) because it can permanently stain the teeth. Taking it after sex to prevent STIs is a separate use: see doxy-PEP.
Ciprofloxacin: what it treats, and its warning. It is a fluoroquinolone. Its label carries the FDA's strongest (boxed) warning: it can cause tendinitis and tendon rupture, nerve damage, effects on the brain and mental health, and worsening of myasthenia gravis. Since 2016 the FDA says that for an uncomplicated UTI, sinusitis and a flare of chronic bronchitis it should be reserved for patients who have no other treatment option.
Cephalexin. It is a cephalosporin used, among other things, for skin infections: see cephalexin for cellulitis.

How a video visit works

We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you. We see adults and children of all ages, in English or Spanish.

Request a visit and pay by card. Choose the doctor visit. Video doctor visits 24/7 — book online and choose your time right away.
Join by video. We send you a secure video link. It works on your phone, tablet or computer. You need to be physically in Puerto Rico during the visit; visitors are welcome.
The doctor assesses you. If appropriate, she prescribes and we send your prescription to your pharmacy. If a test is needed, you get a lab order for a lab near you.

What it costs

It is a doctor visit, with the same price for every age and no membership. There is no extra charge for a prescription (see online prescriptions in Puerto Rico), and a doctor's note after your visit is included. You are charged when you request the visit, with a full refund if the clinic can’t see you. See pricing. The service is run by The Health Initiative, a nonprofit.

When we order a lab test

Sometimes a test helps show whether an infection is bacterial and which antibiotic fits. The CDC notes that several types of tests are used to diagnose strep throat. When the doctor thinks it will help, we give you a lab order for a strep test, a urinalysis or a urine culture at a lab near you, and she goes over the result with you.

If you are prescribed an antibiotic, take it exactly as directed and tell the doctor if you are not getting better.

If it's a virus: feeling better without antibiotics

Antibiotics do not work on viruses. According to the CDC, they do not help colds and runny noses, most sore throats (except strep), flu or most chest colds (bronchitis). The CDC adds that many sinus and ear infections get better without antibiotics.

In those cases the doctor explains how to ease your symptoms at home and which signs should bring you back. For flu, antiviral medicine is an option in some cases; she will assess whether it fits you.

Why not take antibiotics without a prescription?

Common side effects include rash, dizziness, nausea and diarrhea. Serious ones include C. difficile infection, which causes diarrhea that can severely damage the colon. Unneeded antibiotics also help bacteria become resistant, which makes future infections harder to treat.

The CDC says don't save antibiotics for later and don't take antibiotics prescribed for someone else. Ask your pharmacy how to dispose of leftovers.

Puerto Rico follows the same federal law as the rest of the United States: a prescription drug may be dispensed only with a prescription (21 U.S.C. § 353(b)), and in the U.S. and Puerto Rico no antibiotic you take by mouth (pills, capsules or liquids) is approved for over-the-counter sale. The FDA warns that a website that sells prescription medicines without asking for a prescription is not a safe pharmacy. If you think you need an antibiotic, request a visit online 24/7 and the doctor will assess you.

What to have ready for the visit

This helps the doctor decide quickly and safely:

Your symptoms, when they started and whether they are better or worse.
Whether you have had a fever, and the thermometer reading.
Drug allergies, especially to antibiotics.
Every medicine you take, including supplements and over-the-counter products.
Whether you are pregnant or breastfeeding.
Diabetes, kidney or liver problems, or a weakened immune system.
Any antibiotics you took in the last few months, and your pharmacy's name.

Antibiotics for children

The doctor sees children of all ages. On video she checks the throat, ears and symptoms, with your help showing them on camera. If a strep or urine test is needed, we give you a lab order for a lab near you, and if appropriate she prescribes with the dose based on your child's weight. Patients under 21 need a parent or legal guardian on camera with photo ID. See online doctor visits for kids.

How we care for you

We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.

Frequently asked questions

Can a telehealth doctor prescribe antibiotics in Puerto Rico?

Yes. If the video exam points to a bacterial infection and it is appropriate, the doctor prescribes and we send your prescription to your pharmacy. If a test would help, you get a lab order for a lab near you.

Can you buy antibiotics over the counter in Puerto Rico?

Not oral antibiotics: in the U.S. and Puerto Rico no oral antibiotic is approved for over-the-counter sale, and federal law requires a prescription to dispense one. Some antibiotics for the skin, such as bacitracin or neomycin, polymyxin and bacitracin ointments, are sold without a prescription for minor cuts, scrapes and burns. For an infection, the doctor assesses you by video and, if appropriate, prescribes and we send your prescription to your pharmacy.

Will I get an antibiotic for a cold or the flu?

Colds and flu are viruses, and antibiotics do not work on viruses. The doctor tells you how to ease your symptoms and, for some flu cases, assesses whether an antiviral would help.

Can I take leftover antibiotics from last time?

It is not recommended. The CDC advises against saving antibiotics for later or taking someone else's. Have the doctor assess you instead.

What is amoxicillin used for?

Amoxicillin is a penicillin-type antibiotic for certain bacterial infections, such as strep throat and some ear, sinus, skin and urinary infections. It does not work on colds or the flu. If you are allergic to penicillin, tell the doctor.

What is azithromycin used for?

Azithromycin treats certain bacterial infections; the CDC lists it among the preferred antibiotics for whooping cough. It does not help colds or most cases of bronchitis. The FDA warns it can change the heart's rhythm, so the doctor reviews your history and medicines before prescribing it.

What is doxycycline used for?

Doxycycline is used for chlamydia (the CDC's first choice), acne, rosacea and leptospirosis, among other infections. It makes your skin more sensitive to the sun, can harm the baby during pregnancy, and in children under 8 is used only in specific cases.

Is there an extra charge for the prescription?

No. You pay for the doctor visit, with or without a prescription, and pay for the medicine at your pharmacy. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.

Video visit

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