Overview

• Researchers used over 2,000 standardized-patient visits and knowledge tests across 2,282 providers in 253 towns in Karnataka and Bihar.
• Seventy percent of providers prescribed antibiotics without a bacterial indication for paediatric diarrhoea, which is typically viral.
• Sixty-two percent of providers who knew antibiotics were inappropriate still prescribed them, revealing a large knowledge–practice divide.
• Experiments found little role for financial incentives or on-site sales, and a discrete choice survey showed patients do not prefer antibiotic-giving providers.
• The know–do gap was widest among less-trained providers, pointing to interventions that correct provider beliefs, improve caregiver communication, and expand rapid diagnostics.