Clinical Scorecard: Caregivers’ Misreporting of Children’s Symptoms to Secure Antibiotics During Pediatric Visits
At a Glance
Category
Detail
Condition
Caregiver symptom misrepresentation to obtain antibiotics for children
Key Mechanisms
Caregivers may exaggerate existing symptoms or fabricate absent symptoms; reported motivations included perceiving the child as very ill, believing antibiotics were the only helpful intervention, wanting the child to resume responsibilities, and believing they knew the child’s history better than the clinician.
Target Population
Parents, stepparents, and guardians of children younger than 18 years in a US online survey.
Care Setting
Pediatric clinical encounters involving decisions about antibiotics for infection symptoms.
Key Highlights
In this nonprobability survey, 63 of 236 caregivers (26.7%) reported ever misrepresenting a child’s symptoms to obtain antibiotics.
Exaggeration was reported by 57 caregivers (24.2%); fabrication was reported by 51 (23.6%), and 45 (19.1%) reported both.
Among caregivers reporting misrepresentation, 55 (87.3%) said they had obtained antibiotics at least once, and 40 (63.5%) reported feeling that clinicians did not take their symptoms seriously.
Higher odds of reported misrepresentation were associated with often feeling unheard by clinicians, more comorbidities, higher lying acceptability, and lower health literacy; higher antibiotic knowledge was associated with lower odds.
The authors recommend interventions that improve caregiver-clinician communication, acknowledge caregiver concerns, and correct antibiotic misconceptions.
Guideline-Based Recommendations
Diagnosis
The study assessed caregiver-reported exaggeration or fabrication of a child’s symptoms to obtain antibiotics; it did not evaluate a diagnostic protocol for infection.
Management
The authors recommend improving caregiver-clinician communication, acknowledging caregiver concerns, and correcting misconceptions about antibiotics.
Monitoring & Follow-up
The study did not report clinical monitoring recommendations.
Risks
The authors state that symptom misrepresentation may contribute to antibiotic overuse in pediatric care and complicate prescribing decisions and antibiotic stewardship.
Findings warrant cautious interpretation because the sample was nonprobability-based and regression estimates were exploratory; social desirability bias may have led to underreporting.
Patient & Prescribing Data
The analysis included 236 US caregivers of children younger than 18 years recruited for an online survey; the mean caregiver age was 41.7 years.
The survey examined caregiver-reported misrepresentation to secure antibiotics, not treatment effectiveness. Among those reporting misrepresentation, most said they had obtained antibiotics at least once.
by Alistair Thorpe, Andrea Gurmankin Levy, Laura D. Scherer, Rachael A. Lee, Julia E. Szymczak, Jeffrey T. Kullgren, Valerie M. Vaughn, William B. Petty, Isabelle L. Palmer, Christina Yen, Angela Fagerlin
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