Prosociality in the Social Dilemma of Antibiotic Prescribing

Abstract Antibiotic prescribing can be conceptualised as a social dilemma in which the overuse of antibiotics, to minimise immediate risks to individual patients, results in a sub-optimal outcome for society (antimicrobial resistance) and increased risks to all patients in the long run. Doctors face the challenge of balancing the interests of individual patients against the collective good when prescribing antibiotics. While evidence suggests that doctors tend to prioritise individual interests over those of the collective, the conventional interpretation of such decisions as selfish may be inappropriate, because most doctors are motivated by prosocial concerns about their patients. This review of antibiotic decision research provides a more nuanced understanding of prosociality in the context of the social dilemma of antibiotic prescribing.