Knowledge Gaps on Antibiotic Risks Fuel Patient Expectations

TOPLINE:

Variables, such as insurance type, clinic type, and education level were predictors of whether patients reporting that antibiotics would help common conditions such as sore throat.

METHODOLOGY:

• Researchers conducted a survey with 564 adults in six public primary care clinics and two private emergency departments in Texas over an 18-month period starting in January.
• Participants included 33% Black patients and 46.6% Hispanic patients, with a median age of 49.7 years.
• Surveys were conducted in person and by telephone, with a $15 payment offered to participants.
• Questions were framed as, “When you have (specific symptom/illness), taking antibiotics will help you get better quickly,” with answers on a five-point scale, ranging from strongly agree to strongly disagree.
• Survey respondents were queried on the effectiveness of antibiotics on treating diarrhea, cold or flu, sinus infection, bronchitis, or any symptom/illness.

TAKEAWAY:

• Lack of knowledge about antibiotic risks was significantly associated with increased expectations for antibiotics for diarrhea (odds ratio [OR], 1.6; 95% CI, 1.1-2.4; P = .01) and cold/flu symptoms (OR, 2.9; 95% CI, 2.0-4.4; P
• Patients receiving care at public clinics were nearly twice as likely to expect antibiotics for diarrhea (OR, 1.8; 95% CI, 1.2-2.8; P = .009) and sore throat (OR, 2.2; 95% CI, 1.5-3.2; P
• Patients with adequate health literacy were 30% less likely to expect antibiotics to help treat diarrhea.
• Overall, 37% of patients lacked knowledge of antibiotic risks.

IN PRACTICE:

Future stewardship interventions to reduce inappropriate patient antibiotic expectations should (1) inform patients of the symptoms/illnesses that antibiotics treat and (2) emphasize the individual harms/risks (or harms/risks to others close to an individual) of antibiotics, study authors wrote.

SOURCE:

The study was led by Lindsey A. Laytner, PhD, MPH, of the Baylor College of Medicine in Houston, and was published online in the Annals of Family Medicine. The study was supported by grants from the Agency for Healthcare Research and Quality and the US Department of Veterans Affairs Health Services Research and Development Service.

LIMITATIONS:

The study may not be fully generalizable to patients in less diverse areas of the United States. Public clinic patients may be more psychosocially and medically complex, affecting their antibiotic expectations. A social desirability response bias may have occurred due to the neutral phrasing of questions. Patient antibiotic expectations may have been impacted by unforeseen contextual changes associated with the COVID-19 pandemic.

DISCLOSURES:

Various authors disclosed receiving grants from the Craig H. Neilsen Foundation, Genentech, VA Health Services Research & Development, and the Texas Academy of Family Physicians, among others.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.