A game theoretic approach reveals that discretizing clinical information can reduce antibiotic misuse

Nat Commun. 2021 Feb 19;12(1):1148. doi: 10.1038/s41467-021-21088-5.

Abstract

The overuse of antibiotics is exacerbating the antibiotic resistance crisis. Since this problem is a classic common-goods dilemma, it naturally lends itself to a game-theoretic analysis. Hence, we designed a model wherein physicians weigh whether antibiotics should be prescribed, given that antibiotic usage depletes its future effectiveness. The physicians' decisions rely on the probability of a bacterial infection before definitive laboratory results are available. We show that the physicians' equilibrium decision rule of antibiotic prescription is not socially optimal. However, we prove that discretizing the information provided to physicians can mitigate the gap between their equilibrium decisions and the social optimum of antibiotic prescription. Despite this problem's complexity, the effectiveness of the discretization solely depends on the type of information available to the physician to determine the nature of infection. This is demonstrated on theoretic distributions and a clinical dataset. Our results provide a game-theory based guide for optimal output of current and future decision support systems of antibiotic prescription.

MeSH terms

  • Anti-Bacterial Agents* / therapeutic use
  • Bacterial Infections / drug therapy
  • Computational Biology
  • Drug Resistance, Bacterial
  • Drug Resistance, Microbial*
  • Drug Resistance, Viral
  • Game Theory*
  • Humans
  • Preventive Medicine / methods
  • Virus Diseases

Substances

  • Anti-Bacterial Agents