Optimizing antibiotic prescribing: collective approaches to managing a common-pool resource

Area of Science:

• Medicine
• Public Health
• Behavioral Economics

Background:

• Antimicrobial resistance (AMR) poses a significant threat to modern medicine.
• AMR is framed as a social dilemma, where individual antibiotic overuse leads to the depletion of a shared resource: antibiotic efficacy.
• This overuse is exacerbated by factors like lack of visibility, delayed consequences, and prescriber roles.

Purpose of the Study:

• To explore the implications of viewing antibiotic overuse as a social dilemma for antimicrobial stewardship.
• To identify strategies for improving antibiotic prescribing behaviors.

Main Methods:

• A narrative review of literature on interventions for resource conservation in social dilemmas was conducted.

Main Results:

• Seven strategies were identified to shift prescriber behavior towards conserving antibiotic efficacy:
• These include defining boundaries, increasing problem visibility, enabling collective choice, monitoring behavior, using social incentives/sanctions, aligning goals, and providing conflict resolution.

Conclusions:

• Characterizing antibiotic stewardship as a social dilemma can make optimizing antibiotic prescribing more manageable.
• This theoretical approach provides a foundation for developing effective interventions to combat AMR.