Disparity in socio-economic status explains India’s antibiotic self-medication pattern: understanding from a game theory perspective

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R Soc Open Sci. 2022 Feb 9;9(2):211872. doi: 10.1098/rsos.211872. eCollection 2022 Feb.


The emergence of antimicrobial resistance has raised serious public health concerns in many low-income countries, including India. Socio-economic determinants such as poverty, health expenditure and awareness accelerate this emergence by influencing the attitudes and care practices of individuals such as self-medication. This practice of self-medication is widespread in many countries, where antibiotics are available without a prescription. Thus, the complex dynamics of drug resistance dictated by economics, human behavior, and disease epidemiology pose a serious threat to the community that has been less emphasized in previous studies. Here, we formulate a game-theoretic model of human choices in self-medication integrating economic growth and disease transmission processes. We show that this adaptive behavior emerges spontaneously in the population through a process of self-reinforcement and continuous feedback from the economy, leading to the emergence of resistances as externalities of human choice under resource constrained situations. . We identify that the disparity between social optimum and individual interest in self-medication is primarily driven by treatment efficacy, health awareness, and public health interventions. Frequent multiple peaks of resistant strains are also seen when individuals mimic others more readily and self-medication is more likely. Our model illustrates that timely public health intervention for financial risk protection and antibiotic management policies can improve the epidemiological situation and prevent economic collapse.

PMID:35154800 | PMC:PMC8826305 | DOI:10.1098/rsos.211872