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Computational and Mathematical Methods in Medicine
Volume 2014, Article ID 837929, 8 pages
Research Article

Antibiotic Use as a Tragedy of the Commons: A Cross-Sectional Survey

1F.I. Proctor Foundation, University of California, San Francisco, CA 94143-0412, USA
2Fogarty International Center, National Institutes of Health, Bethesda, MD 20892-2220, USA
3Department of Ophthalmology, University of California, San Francisco, CA 94143-0730, USA
4Department of Epidemiology & Biostatistics, University of California, San Francisco, CA 94107-0560, USA

Received 4 May 2013; Revised 10 October 2013; Accepted 31 October 2013; Published 22 January 2014

Academic Editor: Laura Skrip

Copyright © 2014 Kieran S. O'Brien et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Many believe antibiotic use results in a tragedy of the commons, since overuse may lead to antibiotic resistance and limiting use would benefit society. In contrast, mass antibiotic treatment programs are thought to result in community-wide benefits. A survey was conducted to learn the views of infectious disease experts on the individual- and societal-level consequences of antibiotic use. Methods. The survey instrument was designed to elicit opinions on antibiotic use and resistance. It was sent via SurveyMonkey to infectious disease professionals identified through literature searches. Descriptive statistics were used to analyze the data. Results. A total of 1,530 responses were received for a response rate of 9.9%. Nearly all participants believed antibiotic use could result in a tragedy of the commons, at least in certain circumstances (96.0%). Most participants did not believe mass antibiotic treatment programs could produce societal benefits in an antibiotic-free society (91.4%) or in the United States (94.2%), though more believed such programs would benefit antibiotic-free societies compared to the United States (). Conclusions. The experts surveyed believe that antibiotic use can result in a tragedy of the commons and do not believe that mass treatment programs benefit individuals or society.