Literature DB >> 33608511

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

Maya Diamant1, Shoham Baruch2,3, Eias Kassem4, Khitam Muhsen2, Dov Samet1, Moshe Leshno1, Uri Obolski5,6.   

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.

Entities:  

Year:  2021        PMID: 33608511     DOI: 10.1038/s41467-021-21088-5

Source DB:  PubMed          Journal:  Nat Commun        ISSN: 2041-1723            Impact factor:   14.919


  37 in total

Review 1.  Systematic review and meta-analysis of the efficacy of appropriate empiric antibiotic therapy for sepsis.

Authors:  Mical Paul; Vered Shani; Eli Muchtar; Galia Kariv; Eyal Robenshtok; Leonard Leibovici
Journal:  Antimicrob Agents Chemother       Date:  2010-08-23       Impact factor: 5.191

2.  Estimating the proportion of bystander selection for antibiotic resistance among potentially pathogenic bacterial flora.

Authors:  Christine Tedijanto; Scott W Olesen; Yonatan H Grad; Marc Lipsitch
Journal:  Proc Natl Acad Sci U S A       Date:  2018-12-18       Impact factor: 11.205

Review 3.  Determinants of inappropriate empirical antibiotic treatment: systematic review and meta-analysis.

Authors:  Elena Carrara; Iris Pfeffer; Oren Zusman; Leonard Leibovici; Mical Paul
Journal:  Int J Antimicrob Agents       Date:  2017-12-23       Impact factor: 5.283

4.  Association between appropriate empiric antimicrobial therapy and mortality from bloodstream infections in the intensive care unit.

Authors:  Satoshi Yamaga; Nobuaki Shime
Journal:  J Infect Chemother       Date:  2017-12-29       Impact factor: 2.211

5.  Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.

Authors:  Herman Goossens; Matus Ferech; Robert Vander Stichele; Monique Elseviers
Journal:  Lancet       Date:  2005 Feb 12-18       Impact factor: 79.321

6.  Benefit of appropriate empirical antibiotic treatment: thirty-day mortality and duration of hospital stay.

Authors:  Abigail Fraser; Mical Paul; Nadja Almanasreh; Evelina Tacconelli; Uwe Frank; Roberto Cauda; Sara Borok; Michal Cohen; Steen Andreassen; Anders D Nielsen; Leonard Leibovici
Journal:  Am J Med       Date:  2006-11       Impact factor: 4.965

Review 7.  Antimicrobial use: risk driver of multidrug resistant microorganisms in healthcare settings.

Authors:  Evelina Tacconelli
Journal:  Curr Opin Infect Dis       Date:  2009-08       Impact factor: 4.915

8.  Antibiotic therapy and Clostridium difficile infection - primum non nocere - first do no harm.

Authors:  Grace S Crowther; Mark H Wilcox
Journal:  Infect Drug Resist       Date:  2015-09-15       Impact factor: 4.003

9.  A comparison of two informative SNP-based strategies for typing Pseudomonas aeruginosa isolates from patients with cystic fibrosis.

Authors:  Melanie W Syrmis; Timothy J Kidd; Ralf J Moser; Kay A Ramsay; Kristen M Gibson; Snehal Anuj; Scott C Bell; Claire E Wainwright; Keith Grimwood; Michael Nissen; Theo P Sloots; David M Whiley
Journal:  BMC Infect Dis       Date:  2014-06-05       Impact factor: 3.090

Review 10.  Antimicrobial Resistance: Implications and Costs.

Authors:  Porooshat Dadgostar
Journal:  Infect Drug Resist       Date:  2019-12-20       Impact factor: 4.003

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