Social dilemma in the excess use of antimicrobials incurring antimicrobial resistance
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Updated: Aug 18, 2025

Author Spotlight: Understanding and Detecting Environmental Antimicrobial Resistance by Combining Culture-Based Techniques and Genomics
Published on: July 19, 2024
Hiromu Ito1, Takayuki Wada2, Genki Ichinose3
1Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan. ito.hiromu@nagasaki-u.ac.jp.
Abstract:
The emergence of antimicrobial resistance (AMR) caused by the excess use of antimicrobials has come to be recognized as a global threat to public health. There is a 'tragedy of the commons' type social dilemma behind this excess use of antimicrobials, which should be recognized by all stakeholders. To address this global threat, we thus surveyed eight countries/areas to determine whether people recognize this dilemma and showed that although more than half of the population pays little, if any, attention to it, almost 20% recognize this social dilemma, and 15-30% of those have a positive attitude toward solving that dilemma. We suspect that increasing individual awareness of this social dilemma contributes to decreasing the frequency of AMR emergencies.
Insights
Antimicrobial resistance (AMR) is a global health threat. Recognizing the social dilemma of overuse is key, with some individuals showing willingness to address it, potentially reducing AMR emergencies.
Area of Science:
- Public Health
- Behavioral Economics
- Microbiology
Background:
- Antimicrobial resistance (AMR) poses a significant global public health threat.
- Excessive antimicrobial use, driven by a 'tragedy of the commons' social dilemma, exacerbates AMR.
- Understanding public perception of this dilemma is crucial for developing effective interventions.
Purpose of the Study:
- To assess public recognition of the social dilemma underlying antimicrobial overuse.
- To gauge attitudes towards solving this dilemma across different populations.
- To explore the potential link between awareness and reduction of AMR emergencies.
Main Methods:
- Survey conducted across eight countries/regions.
- Assessed public awareness and attitudes regarding the social dilemma of antimicrobial use.
- Analyzed the relationship between awareness, attitudes, and potential impact on AMR.
Main Results:
- Over half the surveyed population showed little awareness of the social dilemma.
- Approximately 20% of respondents recognized the social dilemma.
- 15-30% of those aware expressed a positive attitude towards solutions.
Conclusions:
- Public awareness of the social dilemma driving antimicrobial overuse is limited.
- A notable minority recognizes the issue and is open to solutions.
- Increasing awareness may be a viable strategy to mitigate antimicrobial resistance emergencies.
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