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Rational prescribing is important in all settings
  1. Imti Choonara
  1. Correspondence to Professor Imti Choonara, Academic Division of Child Health, University of Nottingham, Derbyshire Childrens Hospital, Uttoxeter Road, Derby DE22 3DT, UK; Imti.choonara{at}

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The importance of rational prescribing in low-income and lower-middle-income countries is highlighted by the paper published by Risk and colleagues.1 The authors evaluated the prescribing practices of health professionals treating children under the age of 5 years in 20 different public health centres in The Gambia. There were over 300 young children seen with diarrhoea, and a similar number seen with an upper respiratory tract infection (cough and cold only). Approximately half the children with diarrhoea or an upper respiratory tract infection received antibiotics, and this is clearly inappropriate. WHO and numerous investigators have raised concerns regarding the irrational use of medicines.2 WHO has been instrumental in producing an Essential Medicines List in order to help prescribers choose the most appropriate medicines. Additionally, guidelines, both national and international, have been produced in relation to the treatment of a variety of medical conditions. Despite these various initiatives, WHO has estimated that …

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