A lesson in prescribing

BMJ 2003; 326 doi: (Published 04 January 2003) Cite this as: BMJ 2003;326:36
  1. Philip J West, general practitioner
  1. Boundaries Surgery, Four Marks, Alton

    On a recent visit to KwaZulu Natal, South Africa, I took doxycycline capsules for malaria prophylaxis. For three weeks, while we were on holiday, all went well. We then moved on to Mseleni Mission Hospital, 60 km south of the Mozambique border on the east coast, where I had worked for 21 months before my general practitioner registrar year.

    The night before I was due to begin five weeks' work there, I started feeling some discomfort in my throat. We arrived at Mseleni Mission Hospital at midday, and I went straight to the outpatients and casualty department before spending most of the night in labour ward and theatre. By morning I was feeling quite unwell with retrosternal chest pain, odynophagia, and mild dysphagia. I am …

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