A study by USI, supported by the Swiss National Science Foundation and led by Peter J. Schulz, Full Professor and researcher at the Faculty of Communication, Culture, and Society, shows that doctors’ trust in patients can help curb unnecessary requests for antibiotics and counteract the growing risk of resistance.
Every year, five million people die from bacterial infections due to antibiotic-resistant pathogens. The World Health Organization (WHO) predicts that this number will double by 2050. Although developing new active ingredients and therapies may help slow this trend, it is equally important to use existing drugs responsibly.
"We are interested in understanding the extent to which human behaviour contributes to the problem of antibiotic resistance," says Professor Peter J. Schulz. "Only then can we break the cycle." His team at USI has identified a key factor: the trust that doctors and family doctors place in their patients.
Approximately 90% of antibiotics are prescribed in primary care settings. However, a large portion of these prescriptions is unnecessary, particularly for viral illnesses like colds, as antibiotics are ineffective against them. Despite this, many individuals request antibiotics during their visits and often receive them. According to Schulz, the reasons for this include time constraints during consultations and a reluctance to address potential conflicts.
To further investigate these issues, the study examined the interaction between doctors and patients during the prescribing process. Eight family doctors and 101 patients in the Italian-speaking region of Switzerland were interviewed to gather information about their tendency to request antibiotics. The findings revealed that men, individuals with lower education levels, and those who view themselves as particularly prone to illness are more likely to ask for a prescription.
However, the most interesting finding centres on the role of trust. While it was anticipated that patients’ trust in their doctor would reduce requests, the study showed the opposite: when doctors show trust in their patients, those patients are less likely to request antibiotics. "When people sense that their doctor trusts them, they are less inclined to make such requests," explains Schulz.
This dynamic opens up new perspectives for reducing unnecessary antibiotic consumption. One practical application is deferred prescribing, where a doctor provides a prescription that can be filled only after a few days if symptoms persist or worsen. In cases of mild viral infections, symptoms often resolve on their own without the need for antibiotics.
In countries such as the Netherlands, this method has already significantly reduced the inappropriate use of antibiotics. Schulz is now investigating whether the model can also be successfully applied in the Swiss healthcare system. It is an "empowerment" approach, which aims to involve patients more in their medical decisions. "This does not mean that they can receive antibiotics whenever they want," explains Schulz, "but that the doctor trusts in their ability to correctly assess their own state of health and take the medication only when it is really necessary."
