Medical Prescribing and Antibiotic Resistance: A Game-theoretic Analysis of a Potentially Catastrophic Social Dilemma

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Apr 20

PMID 31002685

Citations 15

Authors

Andrew M Colman

Eva M Krockow

Edmund Chattoe-Brown

Carolyn Tarrant

Affiliations

Soon will be listed here.

Abstract

The availability of antibiotics presents medical practitioners with a prescribing dilemma. On the one hand, antibiotics provide a safe and effective treatment option for patients with bacterial infections, but at a population level, over-prescription reduces their effectiveness by facilitating the evolution of bacteria that are resistant to antibiotic medication. A game-theoretic investigation, including analysis of equilibrium strategies, evolutionarily stability, and replicator dynamics, reveals that rational doctors, motivated to attain the best outcomes for their own patients, will prescribe antibiotics irrespective of the level of antibiotic resistance in the population and the behavior of other doctors, although they would achieve better long-term outcomes if their prescribing were more restrained. Ever-increasing antibiotic resistance may therefore be inevitable unless some means are found of modifying the payoffs of this potentially catastrophic social dilemma.

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