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

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posted on 2019-06-17, 10:31 authored by Andrew M. Colman, Eva M. Krockow, Edmund Chattoe-Brown, Carolyn Tarrant
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.

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 Behaviour

Version

  • VoR (Version of Record)

Published in

PLoS One

Publisher

Public Library of Science

eissn

1932-6203

Acceptance date

2019-04-03

Copyright date

2019

Available date

2019-06-17

Publisher version

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215480

Language

en

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