Digital Footprint and Audience Engagement Among Infectious Diseases Medical Educators on TikTok

Background Short-form video platforms such as TikTok have increasingly become influential channels for medical education, but the rapid growth of unverified health content has raised concerns about the spread of misinformation. Infectious diseases (ID) is a specialty in which accurate, timely public communication is particularly consequential, yet little is known about the presence, output, or audience engagement of credentialed ID educators on TikTok. This study aimed to characterize the digital footprint and interaction metrics of verified ID physicians and pharmacists creating educational content on the platform, contextualized against broader social media health engagement benchmarks. Methods We performed a cross-sectional, observational analysis of public TikTok accounts identified through six ID-related hashtags (#infectiousdiseases, #infectiousdisease, #infectiousdiseasesphysician, #idmeded, #idfellowship, and #antibiotics). High-volume, consumer-facing hashtags were intentionally included alongside specialist tags to maximize initial search sensitivity, followed by manual post-hoc screening to maintain sample specificity. Accounts were included if they were managed by a credentialed ID physician (MD/DO) or ID pharmacist (PharmD) based in the United States and produced predominantly English-language, ID-focused educational content. Profile-level performance and interaction data were extracted using Collabstr (Collabstr Inc., Vancouver, Canada). Results Of 91 unique profiles identified, 13 accounts (11 physicians, 84.6%; two pharmacists, 15.4%) met the inclusion criteria following multi-stage manual screening. The cohort had a cumulative total of 62,694 followers across all 13 accounts (median 1,012; range 108-27,900). Complete interaction data were available for all accounts. To account for algorithmic non-follower interaction via TikTok's "For You" feed, engagement was evaluated as an unbounded interaction-to-follower ratio: \(\text{Interaction-to-Follower Ratio (%)} = \left( \frac{\text{Average Likes} + \text{Average Comments}} {\text{Total Followers}} \right) \times 100\) The median interaction-to-follower ratio was 25.72%, while the mean ratio was 65.81%, reflecting a small number of viral outlier accounts. Smaller accounts frequently outpaced standard health-niche TikTok engagement benchmarks (1.0%-5.0%), with the highest-performing viral outlier account recording an interaction-to-follower ratio of 439.71% due to massive non-follower distribution. Conclusions Credentialed ID educators remain scarce on TikTok relative to other social media platforms, yet existing accounts demonstrate an outsized algorithmic capacity for audience exposure and interaction efficiency relative to their small follower counts. Academic institutions and public health agencies could meaningfully expand the reach of verified medical education by supporting clinician-created short-form video content.