Convenience and perception
Although the study does not explore the reasons providers are so frequently veering from the recommended treatments, both Hicks and Hyun have some ideas.Hicks said the simplest explanation may be the convenience factor. For example, azithromycin is a once-a-day drug, while some of the first-line drugs need to be taken twice or even three times a day. But Hicks believes there’s also a perception, shared by both provider and patient, that broader may be better, and that using drugs that cover more bacteria makes it less likely that something could be missed.Hyun suggests there’s also a social dynamic going between patients and doctors, where patient expectations—and how doctors perceive those expectations—are playing a role in antibiotic prescribing. “Physicians and providers feel, a lot of the time, that patients walk into their office with a certain level of expectation for antibiotics,” Hyun said.And that, along with the patient’s previous experience, can have an impact on antibiotic selection. So if a patient has previously received a broad-spectrum antibiotic and it worked well, they’ll probably ask for that same antibiotic again. “That can influence the prescriber,” Hyun said.