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Drawing on interview and observational data from public health centres and private primary care surgeries in Johannesburg, Lenore explores local ideas of immunity, resistance and stewardship, and how these influence prescribing practice and the use of common medication. Lenore suggests that health providers operate in a subjunctive mode, making decisions based on their understandings of how risk factors might be mediated by social and economic exigencies.

In explaining the prescription of antibiotics for URTI symptoms, Lenore highlights how decisions to prescribe are based on patient expectations, providers’ understandings of contingencies and taken-for-granted conditions, pathological possibilities and risks of future infection.