Many common infections are caused by germs called viruses. Antibiotic medicines do not kill viruses. Also, many infections caused by germs called bacteria do not need antibiotics. These infections often get better without antibiotic treatment. Excessive use of antibiotics may allow the germs to become resistant to the antibiotic medicines, so that they will not work when they really are needed. They may also sometimes cause side-effects.
This is why antibiotics are not prescribed for many infections.
Many common infections of the nose, throat, sinuses, ears and chest are caused by germs called viruses. Flu-like illnesses are also caused by viruses. Diarrhoea and/or being sick (vomiting) are often due to a viral infection of the gut. If you are normally well, your defence (immune) system is good at fighting off many types of viral infection. An antibiotic medicine is not needed if a virus is causing an infection. This is because:
- Antibiotics do not kill viruses. Antibiotics only kill germs called bacteria.
- Antibiotics may cause side-effects such as diarrhoea, rashes, feeling sick, etc.
- Overuse of antibiotics when they have not been necessary has led to some bacteria becoming resistant to them. This means that some antibiotics will not work when they are really needed.
See the separate leaflet called Treating Your Infection (Public Health England).
You may feel unwell for several days or more until a viral infection clears. Treatment aims to ease symptoms. Treatments that are commonly advised for viral infections include the following:
- Paracetamol or ibuprofen to reduce a high temperature (fever) and to ease aches, pains and headaches.
- Making sure you drink enough to prevent mild loss of water from the body (dehydration). Dehydration may develop if you have a high temperature and it can make a headache and tiredness much worse.
- Do not wrap up, but try to cool down if you have a high temperature. This is particularly important in children. If a child has a high temperature then take their clothes off (in a warm, but not hot, room) and consider giving some paracetamol or ibuprofen.
- Other advice may be given for specific symptoms. For example, decongestants for a blocked nose, etc. Ask a pharmacist for advice.
The immune system can clear most infections caused by germs called bacteria. For example, antibiotic medicines usually do little to speed up recovery of bronchitis, or most ear, nose and throat infections that are caused by bacteria. However, you do need antibiotics if you have certain serious infections caused by bacteria, such as meningitis or pneumonia. When you are ill, doctors are skilled at checking you over to rule out serious illness and to advise if an antibiotic is needed.
If evidence and guidelines suggest that an infection will get better without an antibiotic, it is best not to use one unnecessarily. Excessive use of antibiotics results in the bacteria becoming used to them and adapting. If this happens, bacteria have become "resistant", which means the antibiotic no longer works against them. When this happens it means that doctors may have no useful treatment for infections which are serious and life-threatening
Occasionally, mild infections caused by germs (viral or bacterial) develop into more serious infections. See a doctor to review the situation if the illness appears to change, becomes worse, does not go after a few days, or if you are worried about any new symptom that develops. If your illness has worsened, or if you have developed complications, it may be that you now do need an antibiotic. If this is the case, your doctor will prescribe an antibiotic if it is needed.
Occasionally you may be given a "back-up" prescription for an antibiotic to take if your condition gets worse. If this is the case, your doctor will give you instructions so you know in what situation you should start taking the medication. If you are not sure, call or see your doctor for advice.
Op-Med is a collection of original articles contributed by Doximity members.
I’m really miserable and need that 5 day antibiotic to get better faster.
Ninety-eight percent of the time it is a viral infection and will resolve without antibiotics.
But I can’t breathe and I can’t sleep.
You can use salt water rinses and decongestant nose spray.
But my face feels like there is a blown up balloon inside.
Try applying a warm towel to your face.
And I’m feverish and having sweats at night.
Your temp is 99.2 degrees. You can use ibuprofen or acetominophen.
But my snot is green.
That’s not unusual with viral upper respiratory infections.
And my teeth are starting to hurt and my ears are popping.
Let me know if that is not resolving in a week or so.
But I’m starting to cough.
Your lungs are clear so breathe steam, push fluids and prop up with an extra pillow.
But sometimes I cough to the point of gagging.
You can consider using this cough suppressant prescription.
But I always end up needing antibiotics.
There’s plenty of evidence they can do more harm than good. They really aren’t indicated at this point in your illness.
But I always get better faster with antibiotics.
Studies show that two weeks later there is no difference in symptoms between those treated with antibiotics and those who did self-care only.
But I have a really hard week coming up and I won’t be able to rest.
This may be your body’s way of saying that you need to evaluate your priorities.
But I just waited an hour to see you.
I really am sorry about the wait; there are a lot of sick people with this viral thing going around.
But I paid $30 co-pay today for this visit.
We do appreciate you paying so promptly on the day of service.
But I can go down the street to the walk-in clinic and for $145 they will write me an antibiotic prescription without making me feel guilty for asking.
I wouldn’t recommend taking unnecessary medication that can lead to bacterial resistance, side effects and allergic reactions. I think you can be spared the expense, inconvenience and potential risk of taking something you don’t really need.
So that’s it? Salt water rinses and wait it out? That’s all you can offer?
Let me know if your symptoms are unresolved in the next week or so.
So you spent all that time in school just to tell people they don’t need medicine?
I believe I help people heal themselves and educate them about when they do need medicine.
I’m going to go find a real doctor.
A real doctor will first do no harm. I wish you the best.
Dr. Emily Gibson is a family physician, farmer, poet, wife, mother and grandmother. She has worked in inner city primary care, community and rural health, detox and sexual assault centers, and as the medical director of a University Student Health Center for three decades. Both a photographer and writer, she shares daily about her life and work on her Barnstorming blog.
Dr. Gibson is a 2018–2019 Doximity Author.
All opinions published on Op-Med are the author’s and do not reflect the official position of Doximity or its editors. Op-Med is a safe space for free expression and diverse perspectives. For more information, or to submit your own opinion, please see our submission guidelines or email .
Antibiotics treat infections that are caused by bacteria. Since colds are caused by viruses, antibiotics won’t help at all. One way to look at the differences between viruses and bacteria is to compare them with being attacked by a bear versus a swarm of bees. You can shoot a bear, but a bullet won’t stop a swarm of bees.
However, sometimes a viral infection will lead to a bacterial infection. For instance, you may develop a sinus infection as a result of having a cold. A virus can cause your sinuses to hurt, but if you have a fever over 100.4 ͦ F or your symptoms appear to get worse rather than better after 10 days, your medical provider may prescribe antibiotics.
Some people insist on being prescribed antibiotics, hoping to be safe rather than sorry. However, when people misuse antibiotics they risk building up resistance. Antibiotic resistance is a major health threat in the United States and worldwide, putting us at risk of dying from simple infections. November 18 through 24 is National Antibiotic Awareness Week and an opportunity to learn more about this.
Have you ever left your health care provider’s office feeling frustrated that you didn’t get an antibiotic for a sinus infection, sore throat, or ear infection? If you answered yes, you are not alone. Each year, millions of people visit their provider looking for antibiotics to cure infections. The reality is that most of these illness are caused by viruses and do not need antibiotics to get better. This includes the common cold, sore throats that are not caused by Strep, most coughs, bronchitis, ear infections and sinus infections. Yes, I said ear infections and sinus infections!
How can my doctor tell whether my illness is caused by a virus or bacteria? Though there is no easy way to tell for sure, infections caused by bacteria often take on certain characteristics. They tend to last longer, cause a fever of 100.4 degrees or greater, and may make people sick enough to be hospitalized. Evidence shows that infections lasting 10 days or longer are more likely caused by bacteria, and infections lasting less than that are caused by viruses.
At this point, you might be shaking your head in disbelief, or asking “How can that be?” You might even wonder why your doctor isn’t treating you “just in case.” After all, 10 days is a long time to wait when you are feeling ill. The answer is tri-fold:
1. Antibiotics don’t work for viruses. Most of the time, these common infections are caused by viruses. Antibiotics work by destroying bacterial cell membranes and bacterial replication. Since viruses don’t have these components, antibiotics do nothing to fight them.
2. Antibiotics have side effects. If you take antibiotics for a viral infection, you are putting yourself at risk for side effects. All antibiotics may cause diarrhea and nausea. Some are hard on your kidneys, liver or other body parts. Some side effects can be life threatening, such as an allergic reaction. Every antibiotic can have side effects.
3. Using antibiotics to treat viruses causes superbugs. Superbugs are bacteria that become resistant to antibiotics. This happens when antibiotics are inappropriately used to treat viral infections. When someone gets an infection caused by a superbug, antibiotics don’t work. Thousands of people die from these infections every year. Infants, young children and elderly are at greatest risk. These deaths are preventable – but only if antibiotics are used correctly.
The next time you see your provider for an infection, try to be a good steward of antibiotic use. If he or she determines that you do not need antibiotics, realize the greater impact you have by avoiding these medications for viral illnesses.