Nearly three in 10 adults say they lied for antibiotics

Clinical takeaway: Examine and test before prescribing, even when symptoms sound severe. Acknowledging concerns may leave less reason to misrepresent. 

Outpatient clinicians in the US write roughly 256 million antibiotic prescriptions each year, and unnecessary use contributes to antibiotic resistance while exposing patients to avoidable adverse effects and allergic reactions. Limiting that harm requires prescribing antibiotics only when indicated, a decision that can be clinically ambiguous and often depends on patients' reports of symptom onset, severity, and duration.

Clinicians who believe a patient expects antibiotics are more likely to prescribe them. Less is known about patients who knowingly exaggerate or fabricate symptoms to obtain a prescription, undermining the symptom history clinicians rely on to guide treatment decisions. A new survey of US adults puts numbers on how often people report doing so and why.

Nearly three in 10 adults reported ever misrepresenting symptoms, either by exaggerating or inventing them, to obtain antibiotics from a clinician, and three-quarters said the strategy had succeeded at least once. Nearly all reported exaggerating real symptoms, while about half said they had both exaggerated and fabricated symptoms. Cold-like symptoms were the most commonly exaggerated or invented.

Share of adults who misrepresented, by symptom type: 

• Cold-like, such as cough or sore throat: 66% 
• Stomach: 49% 
• Joint or muscle pain: 46% 
• No specific symptom, just feeling unwell: 37% 
• Eye: 35% 
• Skin: 32% 
• Urinary: 31% 
• Don’t remember which symptoms: 21% 

Roughly six in 10 respondents cited each of three reasons for misrepresenting symptoms: feeling seriously ill, believing antibiotics were the only treatment that would help, and wanting to return to work or other responsibilities sooner. Fewer than three in 10 reported regret, and when they did, it was more often driven by side effects or a lack of benefit than by the dishonesty itself.

Feeling dismissed distinguished the groups: just under half of adults who misrepresented symptoms said clinicians often do not take their concerns seriously, compared with about one in five of those who did not. After adjustment, that perception was associated with roughly double the odds of symptom misrepresentation. Adults younger than 56 had about three times the odds of those aged 65 and older. Believing that antibiotic resistance is a hoax and needing help reading health information were also associated with higher odds, while stronger antibiotic knowledge was linked to lower odds. Gender, race, and ethnicity were not associated with symptom misrepresentation.

Just over one in four caregivers surveyed reported ever misrepresenting a child’s symptoms to obtain antibiotics, and nearly nine in 10 said the strategy had succeeded at least once. Caregivers who often felt dismissed by clinicians had more than three times the odds of doing so, while lower health literacy was also associated with higher odds. Greater antibiotic knowledge, by contrast, was linked to lower odds of symptom misrepresentation.

Researchers surveyed 959 US adults online in early 2026 through a commercial panel. The nonprobability sample describes these respondents rather than the broader US population, and participants self-reported whether they had ever misrepresented symptoms. The regression analyses were exploratory. A companion analysis included 236 caregivers of children younger than 18 drawn from the same survey.

Adults who misrepresented symptoms cited three main sources for what to say: their own experiences, friends or family, and clinicians. Fewer than half said there was anyone they would listen to if advised to stop.

“In fact, of the 8 categories offered that patients could have exaggerated or made up to get antibiotics, only 1 of them (urinary symptoms) clearly justified antibiotic prescribing.” Jeffrey Linder, MD, MPH, of the division of general internal medicine at Northwestern University Feinberg School of Medicine, argues in an accompanying commentary. “While clinicians might interpret patients’ symptom maximization and questions as demands for antibiotics, symptoms do not determine the indication, a diagnosis does.” 

He adds: “prescribers should be asking themselves, ‘is this prescription more likely to help my patient or hurt them?’” 

Sources: Thorpe A, et al. (2026 Oct 30) JAMA Netw Open. Symptom Misrepresentation to Obtain Antibiotics; Thorpe A, et al. (2026 Oct 30) JAMA Netw Open. Caregiver Symptom Misrepresentation to Obtain Antibiotics in Pediatric Encounters