‘If penicillin is  good for pneumonia, it should be good for people coughing up yellow spit.’  This exploration will begin with some ‘inside info’ on the discovery of penicillin and take us through the decades of ‘assumption based medicine’ that led us to the parallel pandemic of antibiotic resistance. It took us 30 years to bring general practice into the world of generating its own evidence and stop accepting ‘hand me down evidence’ from the ‘disease palaces’. We will consider wisdom from the  founding fathers of the discipline of general practice to consider what can be done to change the ‘toxic storm’ behind the overuse of antibiotics in the community: one approach is more point of care testing in primary care to guide antibiotic prescribing.  We will cover some of the methods for evaluating point of care tests, and some of the landmark trials in the community that are finding out if these tests really do result in improved care. 

The next frontier of concern in this broad field is the threat of antiviral resistance. Have we learned anything from the history of antibiotic development and use when it comes to figuring out who should be treated with the emerging novel antiviral drugs, and how these decisions might impact on antiviral resistance? Methods and findings from large scale ‘democratic’ trials in the community about novel antivirals will be summarised, and a vision developed for embedding trials that both optimise antimicrobial use and also strengthen primary care.  So the scope and ambition of the master class will be vast, ranging from the historical and philosophical to practical clinical updates; if nothing else, the story it tells is intriguing!