Doctors’ decisions to prescribe antibiotics are strongly influenced by their own use of and attitudes toward antibiotics—and even more so by their beliefs about their peers’ behavior. A new study published in Kyklos shows that Swedish doctors who perceive their colleagues as being restrictive about antibiotic prescriptions are more likely to refrain from prescribing the medication themselves.

The study, by researchers from the School of Business, Economics and Law at the University of Gothenburg, 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 behavior of doctors play a role in the fight against resistance,” says Elina Lampi, Associate Professor of Economics in the School of Business, Economics and Law, University of Gothenburg.

Colleagues’ behavior 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 behaviors is interesting from a policy perspective. It is important to be aware that private attitudes and behaviors influence antibiotic prescribing among doctors. However, when comparing the two, professional norms—that is, the prescribing behavior 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.