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  1. Richard Lehman, MRCGP, MA
  1. Department of Primary Care, Oxford University
 Oxford, UK

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    It is a truth universally acknowledged that a primary care doctor in search of an exit strategy will often prescribe an antibiotic. This is the subject of much research and many sermons, especially from countries with a Calvinist tradition, such as Scotland or the Netherlands. Sinning doctors will often claim to be penitent, but then immediately sin again. Is there any hope that we can be numbered among the Elect? Preaching to doctors alone has little effect, according to the Cochrane review of interventions to improve antibiotic prescribing in ambulatory care (CD003539): preaching to patients and the public in addition can succeed. A handheld computer can remind doctors not to backslide (

    ) . The simple compromise of a delayed prescription, suggesting to the patient or parent that they can safely wait to see if the problem resolves, is also valid (see previous Cochrane review, CD004417). All these studies work on the assumption that antibiotics have no effect on non-bacterial infections. But the …

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