When do you really need an antibiotic for a respiratory illness? Probably not very often. However, some doctors still prescribe antibiotics inappropriately despite the risks, in large part because patients expect them.
The common cold, sore throats, sinus infections, coughs, and bronchitis -- these acute respiratory infections (ARIs) send more people to the doctor than any other kind of illness. About 75% of the time, people go home with a prescription for an antibiotic— -- whether they need -the antibiotic or not.
Indeed, over 90% of respiratory infections trace to viruses, upon which antibiotics have no effect whatsoever because they kill only bacteria, not viruses. Studies show that patients like to receive a prescription for an antibiotic; but there are real downsides to unwarranted use of antibiotics.
Medical researchers continue to refine understanding of just who should get antibiotics for ARIs and why. Here are some general rules of thumb:
Antibiotics do not combat the common cold. They could make you sick and offer no benefit. The only proven treatment effective for shortening the duration of the common cold (slightly, if you start quickly at the first sign of symptoms) is zinc, and the taste of zinc lozenges is so bad that the treatment may be worse than the disease. During flu season, immediate treatment with an antiviral drug such as oseltamivir (Tamiflu) may help you recover from influenza somewhat sooner.
For an otherwise healthy individual who has a “chest cold” (acute bronchitis), research shows that antibiotics offer little to no benefit in reducing either the severity or duration of symptoms.
For sinusitis (sinus infection), immediate use of antibiotics is not necessarily beneficial. However, when symptoms have persisted for more than about 10 days, or if you have severe symptoms such as fever, facial swelling, or facial pain, antibiotics may help.
Generally, antibiotics are not helpful for sore throat, unless a test confirms the presence of a bacterial infection with Streptococcus ("strep throat”).
Antibiotics are used to treat pneumonia, a viral or bacterial infection of the lungs.
Diarrhea is a common side effect of antibiotics and develops more frequently with longer durations of antibiotic treatment.
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