Action bias in the public’s clinically inappropriate expectations for antibiotics

Clinical guidelines recommend that physicians educate patients about illnesses and antibiotics to eliminate inappropriate preferences for antibiotics. We expected that information provision about illnesses and antibiotics would reduce but not eliminate inappropriate preferences for antibiotics and that cognitive biases could explain why some people resist the effect of information provision. In two experiments, participants (n1 = 424; n2 = 434) either received incomplete information (about the viral aetiology of their infection) or complete information (about viral aetiology and the ineffectiveness and harms of taking antibiotics), before deciding to rest or take antibiotics. Those in the complete information conditions responded to items on four biases: action bias, social norm, source discrediting, and information neglect. In two follow-up experiments (n1 = 150; n2 = 732), we aimed to counteract the action bias by reframing the perception of the resting option as an action. Complete information provision reduced but did not eliminate inappropriate preferences for antibiotics. Around 10% of people wanted antibiotics even when informed they are harmful and offer no benefit and even when the alternative option (i.e., rest) was framed as an active treatment option. Results suggest an action bias underpins this preference but appears challenging to counteract.