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Hi Bethany,
I wanted to chime in and provide my thoughts on other factors that may contribute to overprescription as well as possible solutions. I think you have hit on an incredibly important problem that is contributing to the antibiotic resistance crisis. One study estimated that doctors in the U.S. prescribed antibiotics for sore throats in 60% of visits (for sore throat), despite streptococcal pharyngitis being the only cause of sore throat that warrants antibiotic prescription and this condition represents about 10% of sore throat visits (1,2). Factors that might contribute to physician antibiotic overprescription include lack of sleep, hunger, hurried environment, and lack of attention (among others) (3). I completely agree that patient education is an important factor. 88% of studies on patient expectations with antibiotics found that patients overestimate the benefits of antibiotics and 67% of these studies found patients underestimate the harms (4). I think one factor that could lead to this perception is the marketing of drugs in media which leads to a culture that believes that every ailment requires a pill (3). Regulating the pharmaceutical industry-patient relationship in media may help change the culture. In 2013, the CDC recommended antibiotic stewardship which is when physicians only prescribe antibiotics when they are needed for treatment or to prevent disease (5). Furthermore, prescribing the correct antibiotic and dose are also essential (5). In conclusion, I think that patient, physician, and societal factors contribute to antibiotic overprescription. Physicians should take the lead on this issue and help to change the culture of antibiotic overprescription and educate patients on the real harms and benefits of antibiotics.
Thanks for starting the discussion,
James

1. Barnett M. L., Linder J. A. 2014. Antibiotic prescribing to adults with sore throat in the United States, 1997-2010. JAMA Intern Med.
2. Wessels M. R. 2011. Clinical practice. Streptococcal pharyngitis. N Engl J Med.
3. Feller E. 2019. Why do doctors overprescribe antibiotics? Rhode Island Med J
4. Hoffmann T. C., Mar C. D. 2015. Patients' expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med.
5. CDC. 2013. Antibiotic resistance threats in the united stated, 2013.

Name
James King

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