In Brief | Infectious Diseases & Primary Care
Antimicrobial Stewardship: Nearly Three in Ten US Adults Report Misrepresenting Symptoms to Obtain Antibiotics
02 November 2026
Study Snapshot
| Design | Survey study; national non-probability sample recruited to an online survey, 8 January to 13 February 2026 |
| Population | 959 US adults from 1 371 eligible participants; mean (SD) age 50.7 (17.6) years; 478 (49.8%) female |
| Outcomes | Self-reported exaggeration and fabrication of symptoms in pursuit of an antibiotic prescription, and the motivations behind it |
| Headline result | 27.9% reported ever misrepresenting symptoms; of these, 40.3% exaggerated, 7.1% fabricated and 52.6% did both |
Summary
A survey study published in JAMA Network Open on 30 October 2026 reports that a substantial minority of American adults have deliberately overstated or invented symptoms in order to secure an antibiotic prescription. Among 959 respondents, 268 (27.9%) said they had done so at some point. Within that group, 108 (40.3%) had overstated symptoms they genuinely had, 19 (7.1%) had described symptoms they did not have, and 141 (52.6%) had done both. Respiratory presentations dominated: 176 respondents (65.7%) named cold-like symptoms such as cough and sore throat. The reasons most often endorsed were how unwell the person felt, a belief that antibiotics would work, pressure to get back to work or other obligations, and a wish to have a say in their own treatment. A companion survey of 256 caregivers, published alongside it, found a comparable pattern in paediatric encounters.
Who Was More Likely to Do It
Age showed the steepest gradient. Respondents aged 18 to 33 had more than three times the odds of those aged 65 and over (OR 3.20; 95% CI 1.58–6.63), and the 34-to-55 band was close behind (OR 3.05; 95% CI 1.55–6.17).
Needing help to read health materials was also associated with raised odds (OR 2.40; 95% CI 1.62–3.54), as was often feeling that clinicians did not take one's symptoms seriously (OR 2.19; 95% CI 1.49–3.22) and regarding antibiotic resistance as a hoax (OR 1.98; 95% CI 1.34–2.93).
Disliking taking antibiotics (OR 0.89; 95% CI 0.81–0.99) and scoring higher on antibiotic knowledge (OR 0.73; 95% CI 0.58–0.91) were each associated with lower odds. Further associations were reported in the full study
Why It Matters
The two characteristics associated with lower odds — better antibiotic knowledge and a dislike of taking antibiotics — are both modifiable, and both sit squarely within the remit of antimicrobial stewardship. A does the finding that feeling dismissed was associated with higher odds: where a consultation leaves a patient feeling unheard, the pressure to embellish appears to rise.
The authors argue for strategies that build antibiotic knowledge and strengthen patient-clinician communication. For prescribers, the practical implication is that a reported symptom history may be shaped by what the patient hopes to leave with, and that a diagnosis rather than a symptom account should drive the decision to prescribe. The survey drew on a US sample and was self-reported, so the prevalence figure should not be read across to other health systems.
Read the Original Study
The original article is published open access under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. This brief is an independent, non-commercial account of the study's findings prepared by The Medical Education Network. It is not a reproduction or an adaptation of the original article, and it does not replace it. Readers are encouraged to consult the full paper at the link above.
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