Beliefs of Peers' Behavior, Clinical Guidelines, and Private Attitudes to Antibiotics as Drivers of Antibiotic Prescribing

ABSTRACT This study examines how doctors' personal views and norms on antibiotics affect their choices when prescribing antibiotics in Sweden. We analyze answers from two surveys, one in 2018 with 357 doctors about their own use and attitudes of antibiotics and another in 2019–2020 with 255 doctors about their prescription behavior. We find that doctors have more knowledge, and concern about antibiotic resistance and use than ordinary citizens, but they also use more antibiotics and are less ready to reduce their personal use of antibiotics. A doctor's choice not to prescribe antibiotics is strongly correlated with the descriptive treatment norms, that is, the perception of what most doctors would do when considering prescribing antibiotics and the guidelines for using antibiotics. There is also a strong correlation between professional and private attitudes: Although doctors themselves use more antibiotics than average people on average, those who are willing to refrain from using antibiotics as a private person are also more willing to avoid prescribing antibiotics to their patients.