Peers and private norms drive doctor's antibiotic prescribing
Private use of antibiotics and professional norms among colleagues influence doctors' decisions regarding antibiotic treatment. This is demonstrated by research from the School of Business, Economics and Law at the University of Gothenburg.
Doctors' decisions to prescribe antibiotics are strongly influenced by their own use and attitudes of antibiotics – and even more so by their beliefs of peers’ behaviour. A new study shows that Swedish doctors who perceive their colleagues as being restrictive about antibiotic prescription are more likely to refrain from prescribing the medication themselves. The study also highlights the importance of private norms. Doctors who avoid taking antibiotics in their personal lives tend to be more cautious in their professional roles, and vice versa.
‘Overuse of antibiotics is a key driver of antibiotic resistance. Therefore, the attitudes and prescribing behaviour of doctors play a role in the fight against resistance,’ says Elina Lampi, Associate Professor of Economics at the School of Business, Economics and Law, University of Gothenburg.
Colleagues' behaviour has the greatest impact
The study also reveals that doctors use more antibiotics privately than the general public. They are also less likely to refrain from taking antibiotics when they are ill themselves, despite having greater knowledge of, and concern about, antibiotic resistance than the average person.
'The link between doctors' professional and private behaviours is interesting from a policy perspective. It is important to be aware that private attitudes and behaviours influence antibiotic prescribing among doctors. However, when comparing the two, professional norms — that is, the prescribing behaviour of one’s colleagues — appear to be more influential', says Lampi.
Strengthening a culture of restraint
When deciding whether to prescribe antibiotics, doctors must consider the immediate benefits to the patient against the long-term risks to society. Excessive use of antibiotics leads to the development of resistant bacteria, which pose a growing global threat to public health.
‘Highlighting good examples among colleagues and strengthening a culture of restraint can be part of finding effective ways to slow down antibiotic resistance. Our study shows that social science research is also needed in this area,’ says Elina Lampi.
Antibiotics are used to treat bacterial infections. However, the more they are used, the faster resistance develops, potentially turning once-easy-to-treat infections into life-threatening ones.
Study: 'Beliefs of Peers' Behaviour, Clinical Guidelines, and Private Attitudes to Antibiotics as Drivers of Antibiotic Prescribing' was published in the scientific journal Kyklos (2025). It is based on two surveys completed by the same group of doctors. In the first wave of the survey the doctors answered as private persons, while in the second wave, they answered in their professional role as doctors.
The study forms part of the CARe (Centre for Antibiotic Resistance Research) research programme at the University of Gothenburg, conducted in collaboration with the Sahlgrenska Academy and the SOM Institute. Authors: Fredrik Carlsson, Gunnar Jacobsson, Elina Lampi and Björn Rönnerstrand.
Contact: Elina Lampi, Associate Professor of Economics at the School of Business, Economics and Law, University of Gothenburg, elina.lampi@economics.gu.se,+46 (0)31 786 13 93
Elin Hellström
Communications Officer
School of Business, Economics and Law at the University of Gothenburg
Phone: +4676-618 66 17
E-mail: elin.hellstrom@handels.gu.se
School of Business, Economics and Law at the University of Gothenburg
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