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Recovery attributions and future expectations for antibiotics after precautionary prescribing.

Elisabeth D C Sievert^1,2, Lars Korn^1,2, Rian Gross³

¹Health Communication, Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany.

European Journal of Public Health

|August 26, 2025

Summary

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Precautionary antibiotic prescribing can lead patients to believe antibiotics caused their recovery, increasing future demand. Providing information on self-limiting illnesses can improve patient beliefs and support sustainable antibiotic use.

Area of Science:

Public Health
Health Psychology
Behavioral Science

Background:

Antibiotic overuse is a major public health concern.
Precautionary antibiotic prescribing, often to meet patient expectations, can reinforce beliefs in antibiotic necessity.
Understanding how communication influences patient beliefs is crucial for antibiotic stewardship.

Purpose of the Study:

To investigate how communicating precautionary antibiotic prescribing affects patients' causal beliefs about recovery.
To examine how these causal beliefs influence future expectations for antibiotic use.
To assess the impact of base-rate information on patient attributions and expectations.

Main Methods:

Two preregistered online experiments with UK adults (N=252 and N=2448).

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Published on: January 5, 2018

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Published on: August 30, 2018

Antibiotic Dereplication Using the Antibiotic Resistance Platform

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Published on: January 5, 2018

Participants imagined an ear infection, received a precautionary antibiotic prescription, and recovered.

Manipulation of whether participants received statistical information on self-limiting recovery likelihood before the prescription.

Main Results:

Participants predominantly attributed recovery to antibiotics, even with information on self-limiting illness.
This attribution correlated with stronger expectations for future antibiotic prescriptions.
Providing base-rate information on self-limiting recovery partially corrected causal beliefs.

Conclusions:

Precautionary prescribing can unintentionally shape patient beliefs about antibiotic efficacy, driving future demand.
Communicating the likelihood of self-limiting recovery can mitigate inappropriate antibiotic expectations.
This approach supports more prudent and sustainable antibiotic prescribing practices.