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Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma

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  • Andrew M Colman
  • Eva M Krockow
  • Edmund Chattoe-Brown
  • Carolyn Tarrant

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.

Suggested Citation

  • Andrew M Colman & Eva M Krockow & Edmund Chattoe-Brown & Carolyn Tarrant, 2019. "Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-13, April.
    • Handle: RePEc:plo:pone00:0215480
    DOI: 10.1371/journal.pone.0215480
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    References listed on IDEAS

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    1. Travis C Porco & Daozhou Gao & James C Scott & Eunha Shim & Wayne T Enanoria & Alison P Galvani & Thomas M Lietman, 2012. "When Does Overuse of Antibiotics Become a Tragedy of the Commons?," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-12, December.
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    Cited by:

    1. Niklas Harring & Eva M. Krockow, 2021. "The social dilemmas of climate change and antibiotic resistance: an analytic comparison and discussion of policy implications," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-9, December.
    2. Lu Gram & Rolando Granados & Eva M. Krockow & Nayreen Daruwalla & David Osrin, 2021. "Modelling collective action to change social norms around domestic violence: social dilemmas and the role of altruism," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-15, December.

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