Over a quarter of US adults and caregivers have lied to a clinician to get antibiotics, according to two studies published Friday in JAMA Network Open. A team led by Alistair Thorpe at the University of Utah analyzed online survey responses from 959 valid, complete submissions. Of those, 268 respondents (28 percent) reported misrepresenting their symptoms to get antibiotics. Among caregivers, 63 (27 percent) reported misrepresenting a child's symptoms.
Most of the lies involved exaggerating symptoms, making up symptoms, or both. The most common falsehoods were cold-related symptoms such as fever, cough and sore throat, reported by 65 percent of dishonest patients. Colds are caused by viruses, which antibiotics do not treat.
The lies usually worked. The report says 77 percent of adult patients and 87 percent of caregivers said their misrepresentations led to the prescriptions they wanted.
Respondents gave several reasons for lying. They said their illness or a child's illness was severe, that antibiotics were the only thing that would help, that antibiotics would get them back to work or school faster, or that they should decide their own treatment. Respondents who lied were more likely to say their symptoms were not taken seriously by clinicians, and more likely to believe antibiotic resistance is a hoax.
Jeffrey Linder of Northwestern University Feinberg School of Medicine, in an accompanying commentary, wrote that of eight symptom categories patients could have exaggerated or invented, only urinary symptoms clearly justified antibiotic prescribing. He also said the larger concern may be the erosion of trust between clinicians and patients.
The report links unnecessary antibiotic use to drug resistance. The Centers for Disease Control and Prevention, in an updated report released this week, said drug-resistant bacteria and fungi cause 9.7 million infections and 50,800 deaths in the US each year.