Objective:

Assess how often US caregivers misrepresent children’s symptoms to obtain antibiotics, their reasons, and characteristics associated with this behavior.

Approach:

• Design and participants: Online survey of a national, nonprobability sample recruited January 8 to February 13, 2026. Analyses included 236 parents, stepparents, or guardians of children younger than 18 years.
• Measures and analysis: Caregivers reported symptom exaggeration or fabrication to obtain antibiotics, reasons for misrepresentation, and antibiotic-related beliefs and experiences. Multiple logistic regression examined associated characteristics.

Key Findings:

• Sixty-three caregivers (26.7%) reported ever misrepresenting a child’s symptoms to obtain antibiotics; 57 (24.2%) reported exaggeration, 51 (23.6%) reported fabrication, 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 often feeling that clinicians did not take their concerns seriously.
• Commonly endorsed reasons 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 medical history better than the clinician.
• Higher odds of reported misrepresentation were associated with often feeling unheard by clinicians (aOR, 3.34; 95% CI, 1.44-7.99), more comorbidities (aOR, 1.24; 95% CI, 1.02-1.54), higher lying acceptability scores (aOR, 2.06; 95% CI, 1.33-3.31), and lower health literacy (aOR, 2.50; 95% CI, 1.06-6.05). Higher antibiotic knowledge scores were associated with lower odds (aOR, 0.55; 95% CI, 0.31-0.93).

Interpretation:

The authors state that symptom misrepresentation may contribute to antibiotic overuse in pediatric care. They report that misrepresentation was associated with caregivers often feeling that clinicians did not take their concerns seriously.

Limitations:

• The nonprobability sample and exploratory regression estimates warrant cautious interpretation.
• Social desirability bias may have led to underreporting.

Conclusion:

The authors identify symptom misrepresentation as a potentially modifiable factor in pediatric antibiotic overuse and propose improving caregiver-clinician communication, acknowledging caregiver concerns, and correcting misconceptions.

Sources:

• Article context provided in the prompt