The Tragedy of the Commons by Garrett Hardin, 1968 was a seminal work. His central idea concerns ‘resources’ held in common, that degrade or diminish if left to the self interest of individuals. He argues that the problems that arise with allocation and preservation of such resources cannot be solved by technical answers alone – most importantly, a change in attitudes and behaviour towards a cooperative/collaborative approach is required.
Antimicrobials represent a scarce resource that is unlikely to be replenished in the short term to a significant degree by new drug discovery (technical fix). Antibiotic resistance represents a Tragedy of the Commons in Hardin’s sense. Antimicrobial stewardship seeks to persuade prescribers to collectively preserve the antibiotic resource through collaborative action that has potential to benefit individual patients and the wider public health.