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BACKGROUND: General practitioner (GP) follow up is important in the management of patients who are discharged from an ED. OBJECTIVES: To determine the antibiotic compliance and GP follow-up compliance rates in a population of patients seen and discharged from the ED with an antibiotic prescription. To test the hypothesis that the ability to nominate a GP is associated with improved antibiotic and GP follow-up compliance. DESIGN: A prospective cohort study enrolling consecutive adults who were discharged from the ED with antibiotic prescriptions over a 3 month period. Patients were divided into those who nominated a GP at the time of ED presentation and those who did not. Two weeks after enrollment, patients were contacted and asked standardized questions regarding compliance. RESULTS: In total, 123 patients were enrolled into the study. Of patients 76% were able to nominate a GP upon ED presentation. Analysis revealed that those patients who were able to nominate a GP had better compliance to follow up instructions (85 vs 44%, P < 0.01) and improved antibiotic compliance (99 vs 88%, P = 0.01). CONCLUSION: The majority of patients who were seen and discharged from the ED with an antibiotic prescription were able to nominate a GP and this was associated with improved follow-up compliance and antibiotic compliance. Improving follow-up compliance and thus the quality of patient care would involve identifying those patients who present to the ED who are unable to nominate a GP.