If You Have a Cold, You Don’t Need an Antibiotic

By: Dr. Joseph Gallagher

Patients often come to my office with symptoms of running nose, sinus congestion and cough. More times than not, they ask me to prescribe an antibiotic and are stunned when I tell them their ailments are caused by viruses – and that antibiotics won’t help.

Some will say something along the lines of: “I’m sick, I must need an antibiotic. My other doctor would give them to me, and they always worked!” It’s a very common misconception that a common cold – caused by an airborne virus – can be cured by an antibiotic. Antibiotics, if prescribed and taken correctly, can usually kill bacteria (the cause of things like sinus infections), but they are useless against viruses, such as the cold and flu.

Dr. Joseph Gallagher

In fact, often the only treatment for a viral infection is to let the illness run its course. Most viral infections tend to resolve on their own without treatment, so care is aimed at providing relief from symptoms like pain, fever and cough.

But figuring out what’s a virus and what’s a bacterial infection can be tricky. Not only can they cause similar symptoms, but some illnesses – like pneumonia, meningitis and diarrhea – can be caused by either a virus or bacteria. And while both viral and bacterial infections are spread in similar ways – coughing and sneezing; contact with infected people (especially kissing or sex); and contact with contaminated surfaces, food, and water – it can take a bit of “detective work” to figure out which a patient is dealing with.

Here are some commonly asked questions to determine the cause of various symptoms:

• Do you have a fever? This is a common symptom of both bacterial and viral illnesses. But, if the flu – a virus – is “going around,” antibiotics won’t be the answer. Your doctor will look to treat your symptoms. Be sure to get a flu shot next season, if possible.
• Have you been sick long? Viral infections that linger can sometimes morph into a more complex problem, such as a sinus infection, if bacteria join in. In those circumstances, your doctor may prescribe an antibiotic.
• What color is it? While green or yellow mucus can often be a sign of a bacterial infection, doctors say that’s an unreliable indicator of the need for an antibiotic. Talk to your doctor if you experience this symptom.
• What does your throat look like? White spots on the tongue can indicate the presence of bacteria. A sore throat without other cold symptoms can mean strep throat, which absolutely requires antibiotics. To be certain, your healthcare provider can do a culture or rapid antigen test.

If you’re sick with cold or flu-like symptoms, don’t automatically reach for – or assume you’ll need – an antibiotic. And, if your physician wants to prescribe one, ask questions about possible side effects. If needed, ask about the possibility of a “narrow spectrum” antibiotic to be used for the shortest duration. Antibiotics should be prescribed and taken with care.

Dr. Joseph Gallagher is a Family Medicine physician with Jefferson Health New Jersey Family Health Services. Visit https://newjersey.jeffersonhealth.org/ or call (856) 218-2312 to learn more.