There are several strategies than can be used when doctors are reluctant to issue antibiotic prescriptions. You can ask patients to get back in touch is they don’t improve, post-date prescriptions, ask patients to come back and collect the prescription if they aren’t feeling better, write the prescription and ask the patient to delay using it or, of course, say no.

A randomised controlled trial of these options was conducted by a group of UK GPs. A total of 889 patients from 25 practices were randomised to one or the other of the options. They found that all the strategies had much the same outcome in terms of symptom severity and all methods resulted in fewer than 40% of patients using antibiotics.

The study showed that with clear advice from the Doctor all methods had similar outcomes. This study is currently shortlisted as the UK research paper of the year  as part of the BMJ Awards and is available from http://www.bmj.com/content/348/bmj.g1606