[Antibiotic use: psychological factors influencing perceptions and behavior of physicians and patients]

Antibiotic resistance threatens the effectiveness of standard therapies. The dynamics of antibiotic resistance are substantially affected by inappropriate antibiotic use. Therefore, this article places humans at the center of efforts to reduce inappropriate antibiotic use, with a focus both on ambulatory and stationary care. We analyze psychological factors that contribute to inappropriate antibiotic prescribing by physicians and to inappropriate use by patients.Drawing on a narrative review, we identify the following physician-side determinants: (i) knowledge and problem awareness, (ii) diagnostic and prognostic uncertainty, (iii) processes related to judgment and decision-making, (iv) social norms and team structures, and (v) relationships with patients. On the patient side, we identify (i) knowledge and problem awareness, (ii) processes related to judgment and decision-making, and (iii) dealing with diagnostic and prognostic uncertainty.For each factor, we present evidence-based measures that can positively influence both appropriate prescribing and use. Systematically integrating these approaches into antibiotic stewardship initiatives can help improve prescribing and consumption practices.