Investigating the know-do gap in antibiotics prescribing: Experimental evidence from India

This study shows that antibiotic overprescribing for pediatric diarrhea in India is mainly driven by a “know-do gap” rather than lack of medical knowledge. While 70% of providers prescribed antibiotics without indication, 62% did so despite knowing it was inappropriate. Eliminating this gap could reduce unnecessary prescribing by 30 percentage points, compared to just 6 points from improving knowledge alone. Randomized experiments revealed that providers prescribe antibiotics because they believe patients expect them—not due to profit motives or lack of alternatives. However, patients did not actually prefer providers who give antibiotics. Thus, interventions correcting provider misperceptions about patient expectations may be more effective than information-based approaches in reducing antibiotic overuse.