journal.pone.0215480.pdf (1.14 MB)
Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma.
journal contribution
posted on 2019-06-17, 10:31 authored by Andrew M. Colman, Eva M. Krockow, Edmund Chattoe-Brown, Carolyn TarrantThe 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.
Funding
This research was funded by the Global Challenges Research Fund, Grant No. ES/P004784/1, awarded by the Economic and Social Research Council (ESRC) on behalf of the Research Councils UK (RCUK) to Carolyn Tarrant, Andrew M. Colman, and Edmund Chattoe-Brown, and by the Leicester Judgment and Decision Making Endowment Fund (Grant Number RM43G0176) awarded to Andrew M. Colman.
History
Citation
PLoS One, 2019, 14(4): e0215480.Author affiliation
/Organisation/COLLEGE OF LIFE SCIENCES/Biological Sciences/Neuroscience, Psychology and BehaviourVersion
- VoR (Version of Record)