Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 36 min ago
Peer-reviewedCC BY-NC-NDJAMA Network Open

Symptom Misrepresentation to Obtain Antibiotics

  • Alistair Thorpe1
  • Andrea Gurmankin Levy2
  • Laura D. Scherer3,4
  • Rachael A. Lee5,6
  • Julia E. Szymczak7
  • Jeffrey T. Kullgren8,9,10,11
  • Valerie M. Vaughn1,12,13
  • William B. Petty1
  • Isabelle L. Palmer14
  • Christina Yen15
  • Angela Fagerlin1,13
15 affiliations
  1. 1Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
  2. 2School of Liberal Arts and Education, CT State Community College Middlesex, Middletown, Connecticut
  3. 3Division of Cardiology, University of Colorado School of Medicine, Aurora
  4. 4Veterans Affairs Denver Center for Innovation, Denver, Colorado
  5. 5Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham Heersink School of Medicine, Birmingham
  6. 6Department of Medicine, Division of Infectious Diseases, Birmingham VA Medical Center, Birmingham, Alabama
  7. 7Department of Internal Medicine, Division of Epidemiology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
  8. 8Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  9. 9Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
  10. 10Department of Internal Medicine, University of Michigan Medical School, Ann Arbor
  11. 11Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor
  12. 12Department of Internal Medicine, Division of General Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
  13. 13Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences Center for Innovation, Salt Lake City, Utah
  14. 14Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
  15. 15Division of Infectious Diseases, Department of Medicine, MaineHealth Maine Medical Center, Portland
Read full textDOICite

Abstract

Importance: Misrepresentation of symptoms, whether through exaggeration, omission, or fabrication, can represent an important barrier to effective patient-clinician communication and shared decision-making, including in the context of antibiotic treatment.

Objective: To examine the prevalence, reasons for, and characteristics associated with self-reported misrepresentation of symptoms to obtain antibiotics.

Design, Setting, and Participants: This survey study recruited a national, nonprobability sample of US adults to participate in an online survey from January 8 to February 13, 2026. Data were analyzed from February to March 18, 2026.

Main Outcomes and Measures: Outcomes of interest were 2 types of symptom misrepresentation (exaggeration and fabrication) to obtain antibiotics and the reasons underlying these behaviors. Additional questions measured antibiotic-related beliefs, experiences, and behaviors and demographics.

Results: Of 1371 eligible participants, the final sample included 959 individuals (mean [SD] age of 50.7 [17.6] years; 478 [49.8%] female). Overall, 268 respondents (27.9%) reported ever misrepresenting their symptoms to a clinician to get antibiotics. This included 108 respondents (40.3%) who exaggerated existing symptoms (eg, told their clinician they had a cough for 2 weeks when they only had it for 1 week), 19 respondents (7.1%) who fabricated symptoms (eg, told their clinician they had a fever when they did not), and 141 (52.6%) who did both. Cold-like symptoms (eg, cough, sore throat) were the most frequently misrepresented (176 respondents [65.7%]). The most commonly endorsed reasons for misrepresenting symptoms were illness severity, perceived antibiotic efficacy, returning to responsibilities, and desire for autonomy in their treatment decisions. Younger age (age 18-33 vs ≥65 years: odds ratio [OR], 3.20 [95% CI, 1.58-6.63]; age 34-55 vs ≥65 years: OR, 3.05 [95% CI, 1.55-6.17]), often feeling that clinicians do not take their symptoms seriously (OR, 2.19 [95% CI, 1.49-3.22]), believing that antibiotic resistance is a hoax (OR, 1.98 [95% CI, 1.34-2.93]), reporting more comorbidities (OR, 1.16 [95% CI, 1.05-1.28]), having higher lying-acceptability scores (OR, 1.49 [95% CI, 1.23-1.80]), and needing help reading health materials (OR, 2.40 [95% CI, 1.62-3.54]) were associated with higher odds of reporting symptom misrepresentation to obtain antibiotics. In contrast, dislike of taking antibiotics (OR, 0.89 [95% CI, 0.81-0.99]) and higher antibiotic knowledge (OR, 0.73 [95% CI, 0.58-0.91]) were associated with lower odds of misrepresentation.

Conclusions and Relevance: In this survey study of US adults, nearly 30% of respondents reported misrepresenting symptoms to get antibiotics from a clinician, most commonly cold-like symptoms. Findings highlight the need for strategies to promote antibiotic knowledge and improve patient-clinician communication to address factors contributing to symptom misrepresentation.

Related

  1. Caregiver Symptom Misrepresentation to Obtain Antibiotics in Pediatric Encounters
    Alistair Thorpe, Andrea Gurmankin Levy, Laura D. Scherer +8
    JAMA Network OpenPeer-reviewedCC BY-NC-NDFull text1 citedGeneral medicineCrossrefEurope PMC
  2. Freshwater Quality Criteria for Typical Quinolone Antibiotics: Norfloxacin, Enrofloxacin, and Ciprofloxacin
    Qingyuan Pei, Bingjin He, Bin Zhu +3
    ToxicsPeer-reviewedCC BYFull textPharmacology & toxicologyEurope PMC
  3. The pharmacokinetics of antibiotics in patients with obesity: a systematic review and consensus guidelines for dose adjustments
    Anne-Grete Märtson, Katie Barber, Ryan Crass +8
    The Lancet Infectious DiseasesPeer-reviewedLicence not statedFull text18 citedPharmacology & toxicologyHAL
  4. Quality of antibiotics purchased on Bioko Island and four mainland districts of Equatorial Guinea: a cross-sectional medicine-quality survey
    Harparkash Kaur, Laura Paris, Jeremías Nzamio Mba Eyono +6
    BMJ OpenPeer-reviewedCC BY-NC 4.0Full textEpidemiology & public healthCrossref
  5. Continuous or extended vs intermittent infusions of beta-lactam antibiotics in ICU patients with pneumonia: a systematic review and meta-analysis of randomized controlled trials
    Yi-Xuan Li, Jason A. Roberts, Mohd Abdul-Aziz +1
    Antimicrobial Agents and ChemotherapyPeer-reviewedCC BY 4.0Full text2 citedPharmacology & toxicologyHAL

Cite

BibTeXRIS
BibTeX
@article{thorpe2026symptom,
  title = {{Symptom Misrepresentation to Obtain Antibiotics}},
  author = {Alistair Thorpe and Andrea Gurmankin Levy and Laura D. Scherer and Rachael A. Lee and Julia E. Szymczak and Jeffrey T. Kullgren and Valerie M. Vaughn and William B. Petty and Isabelle L. Palmer and Christina Yen and Angela Fagerlin},
  journal = {JAMA Network Open},
  year = {2026},
  month = oct,
  doi = {10.1001/jamanetworkopen.2026.39559},
  url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2856032},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Symptom Misrepresentation to Obtain Antibiotics
AU  - Alistair Thorpe
AU  - Andrea Gurmankin Levy
AU  - Laura D. Scherer
AU  - Rachael A. Lee
AU  - Julia E. Szymczak
AU  - Jeffrey T. Kullgren
AU  - Valerie M. Vaughn
AU  - William B. Petty
AU  - Isabelle L. Palmer
AU  - Christina Yen
AU  - Angela Fagerlin
PY  - 2026
DA  - 2026/10/01
JO  - JAMA Network Open
DO  - 10.1001/jamanetworkopen.2026.39559
UR  - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2856032
AB  - Importance: Misrepresentation of symptoms, whether through exaggeration, omission, or fabrication, can represent an important barrier to effective patient-clinician communication and shared decision-making, including in the context of antibiotic treatment.  Objective: To examine the prevalence, reasons for, and characteristics associated with self-reported misrepresentation of symptoms to obtain antibiotics.  Design, Setting, and Participants: This survey study recruited a national, nonprobability sample of US adults to participate in an online survey from January 8 to February 13, 2026. Data were analyzed from February to March 18, 2026.  Main Outcomes and Measures: Outcomes of interest were 2 types of symptom misrepresentation (exaggeration and fabrication) to obtain antibiotics and the reasons underlying these behaviors. Additional questions measured antibiotic-related beliefs, experiences, and behaviors and demographics.  Results: Of 1371 eligible participants, the final sample included 959 individuals (mean [SD] age of 50.7 [17.6] years; 478 [49.8%] female). Overall, 268 respondents (27.9%) reported ever misrepresenting their symptoms to a clinician to get antibiotics. This included 108 respondents (40.3%) who exaggerated existing symptoms (eg, told their clinician they had a cough for 2 weeks when they only had it for 1 week), 19 respondents (7.1%) who fabricated symptoms (eg, told their clinician they had a fever when they did not), and 141 (52.6%) who did both. Cold-like symptoms (eg, cough, sore throat) were the most frequently misrepresented (176 respondents [65.7%]). The most commonly endorsed reasons for misrepresenting symptoms were illness severity, perceived antibiotic efficacy, returning to responsibilities, and desire for autonomy in their treatment decisions. Younger age (age 18-33 vs ≥65 years: odds ratio [OR], 3.20 [95% CI, 1.58-6.63]; age 34-55 vs ≥65 years: OR, 3.05 [95% CI, 1.55-6.17]), often feeling that clinicians do not take their symptoms seriously (OR, 2.19 [95% CI, 1.49-3.22]), believing that antibiotic resistance is a hoax (OR, 1.98 [95% CI, 1.34-2.93]), reporting more comorbidities (OR, 1.16 [95% CI, 1.05-1.28]), having higher lying-acceptability scores (OR, 1.49 [95% CI, 1.23-1.80]), and needing help reading health materials (OR, 2.40 [95% CI, 1.62-3.54]) were associated with higher odds of reporting symptom misrepresentation to obtain antibiotics. In contrast, dislike of taking antibiotics (OR, 0.89 [95% CI, 0.81-0.99]) and higher antibiotic knowledge (OR, 0.73 [95% CI, 0.58-0.91]) were associated with lower odds of misrepresentation.  Conclusions and Relevance: In this survey study of US adults, nearly 30% of respondents reported misrepresenting symptoms to get antibiotics from a clinician, most commonly cold-like symptoms. Findings highlight the need for strategies to promote antibiotic knowledge and improve patient-clinician communication to address factors contributing to symptom misrepresentation.
SN  - 2574-3805
ER  -