Nearly 30% of U.S. adults have intentionally misled healthcare providers to obtain antibiotics, according to two surveys published October 30 in JAMA Network Open.
Motivations for Symptom Misrepresentation
The surveys identified common practical pressures driving this behavior. Among the 959 adults who responded (mean age, 50.7 years; 49.8% female), 268 (27.9%) reported ever misrepresenting their symptoms to get antibiotics. Of those, 108 (40.3%) said they exaggerated, 19 (7.1%) said they fabricated symptoms, and 141 (52.6%) did both. Among those who misrepresented, 76.9% said they obtained antibiotics this way at least once.
“When patients don't feel like they can be fully honest about their symptoms…this can represent a really important barrier to effective patient-clinician communication and shared decision-making,” Alistair Thorpe, PhD, a researcher at the University of Utah Spencer Fox Eccles School of Medicine, told CIDRAP News.
Specifically, people who often felt clinicians did not take their symptoms seriously had roughly twice the odds of misrepresenting symptoms, and adults aged 18 to 33 and 34 to 55 had about three times the odds compared to those 65 and older.
The pattern was similar for caregivers. Of the 236 caregivers who responded (mean age, 41.7 years; 51.7% female), 63 (26.7%) reported ever misrepresenting a child’s symptoms to obtain antibiotics. Among these caregivers, 87% reported that their misrepresentation worked at least once. These parents often cited the belief that they understood their child’s medical history better than the provider did.
Motivations for this behavior included feeling very sick, believing antibiotics were the only treatment that would work, or wanting to return to work or school quickly. Among adults, 61% wanted to return to responsibilities faster, while 62% said they felt really sick. Respondents also learned how to misrepresent symptoms from various sources: 43.1% used personal experience, some cited social media, 34.5% mentioned advice from friends or family, and 11.6% named an AI chatbot.
Public Health Risks of Unnecessary Antibiotics
The researchers emphasize that these behaviors carry significant risks. Antibiotics are ineffective against viral infections. Being incorrectly prescribed antibiotics for a prior viral infection can also lead to a powerful association between antibiotics and feeling better, as viral infections usually clear up on their own.
This can lead people to incorrectly credit antibiotics for their recovery. Resistant infections are harder and more expensive to treat, and they can reach anyone, including infants, older relatives, and people having surgery or cancer care. Each unnecessary prescription, repeated across millions of visits, adds to that risk.
Communication Strategies for Clinical Encounters
The survey used an online nonprobability sample and self-reported answers, so the estimates may not represent all Americans precisely. Patients seeking care should describe symptoms honestly and ask whether an illness is viral or bacterial, whether a test would help and how to ease symptoms.
