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Interactive data visualizations of antibiotic use and resistance in North America and Europe
How can we extend the effectiveness of antibiotics as a treatment for infection?
In this report, we examine the problem of antibiotic resistance from a natural resources perspective and propose solutions from an incentive-based perspective. Our purpose is to evaluate policy options that will enable society to make the best use of existing antibiotics, sensibly encourage the discovery of new antibiotics, and give drug companies a greater incentive to sell these new drugs responsibly.
The barriers to addressing the problem of antibiotic resistance all involve conflict between the interest of individual decisionmakers and the interest of society as a whole, now and in the future. Incentive-based policy solutions can help patients, physicians, hospitals, and pharmaceutical companies consider the impact of their decisions on others and give them the opportunity to help the solution evolve.
Antibiotic effectiveness can be thought of as a natural resource, much like oil, fish, or forests (Laxminarayan and Brown 2001; Laxminarayan 2003): it is a resource accessible to anyone who can purchase it. All antibiotic use, appropriate or not, “uses up” some of the effectiveness of that antibiotic, diminishing our ability to use it in the future. Hastening the spread of resistance by overuse of antibiotics is like other shared resource problems, such as global warming or overfishing—a phenomenon referred to as “the tragedy of the commons” (Hardin 1968). Approaching antibiotic resistance as a resource problem is not just a convenient metaphor; it can help shape incentive-altering strategies to use antibiotics in ways that provide the greatest benefit to society, both today and in the future. Such incentives would encourage pharmaceutical companies to develop new antibiotics, and patients and health care providers to use existing antibiotics sustainably.