Over one quarter of people lie to doctors to get antibiotics they likely don't need, according to two studies published Friday in JAMA Network Open. Researchers led by Alistair Thorpe at the University of Utah surveyed over 1,000 adults and found that 28 percent reported misrepresenting symptoms to clinicians to obtain antibiotic prescriptions for themselves or children in their care.
The lies patients told involved exaggerating symptoms, fabricating symptoms, or both. Notably, the false symptoms patients reported were for conditions that antibiotics do not treat. Cold symptoms like fever, cough, and sore throat ranked as the most common falsehoods, despite colds being caused by viruses rather than bacteria.
The fabricated claims largely worked. Seventy-seven percent of adult patients and 87 percent of caregivers said their lies successfully led to antibiotic prescriptions.
Of the 268 respondents who misrepresented symptoms, 108 exaggerated symptoms, 19 fabricated symptoms, and 141 did both. Among 263 caregivers surveyed, 63 (27 percent) reported misrepresenting a child's symptoms to get antibiotics.
Patients who lied tended to be younger, felt their symptoms were dismissed by clinicians, and were more likely to disbelieve that antibiotic resistance is real. They also reported underlying health conditions and greater comfort with lying.
Jeffrey Linder of Northwestern University Feinberg School of Medicine noted in an accompanying commentary that of eight symptom categories patients could have misrepresented, only urinary symptoms clearly justified antibiotic treatment. He wrote that unnecessary antibiotics provide no benefit but carry risk of adverse events, allergic reactions, and disruption of healthy microbiomes, which can enable infections like Clostridioides difficile.
Thorpe's team called for "strategies to improve communication about antibiotics" to address patient concerns and strengthen patient-clinician relationships.