AADanswer_jan_13

Question from: 1/13/97

Answer: This question has a simple answer, but the explanation is a bit complicated. The "common cold" is a respiratory infection caused by many different strains of viruses. Since antibiotics do not work on viruses (they only work on bacteria) it's pretty easy to see that antibiotics are of no use in treating a "cold". The symptoms of a "cold" will last about 2 weeks or so, no matter what you do. Although there is very little one can do to shorten the duration of a "cold", many simple remedies help make the symptoms a bit more tolerable.

Why then, do the majority of people who go to the doctor for a "cold" want antibiotics? Many feel that it makes the symptoms go away faster (medical studies say they do not). Some "want to get started on something right away" so it doesn't get any worse or "turn into something". I doubt this really helps that much either. Most were probably just brought up to expect an antibiotic since it was often given in the past when they had a "cold". We doctors are partially to blame for this misconception since we all wanted to do SOMETHING (anything) to help our patients and we thought that giving an antibiotic for their "cold" would be relatively harmless. Unfortunately, we have created a monster! The overuse of antibiotics has greatly contributed to the development of today's "superbugs" which are resistant to multiple different antibiotics.

There are some pretty good reasons to avoid taking antibiotics unless they are absolutely necessary. We all have "good" bacteria living in our bodies that are vital for normal absorption of nutrients from our intestinal tract. Antibiotics indiscriminately kill off these "good" bacteria which can cause problems like diarrhea and yeast infections. Don't forget about the potential for allergic reactions to the antibiotic or interactions with other medications (such as birth control pills). Some experts feel that use of antibiotics can impair our normal immune system function and may leave us susceptible to infections even more frequently than usual. I personally feel that I get infections less often since I stopped using antibiotics for my own "colds" a number of years ago.

In conclusion, I feel strongly that antibiotics should be reserved for situations in which they are clearly needed. Many times a "secondary infection" with a bacteria follows the "cold" and may need treatment. Only your physician can decide for sure if an antibiotic is needed for a particular infection. This decision is not always very straightforward and should be based on taking a history of the symptoms and doing a physical exam. These decisions are difficult, if not impossible, to make by telephone even if your symptoms seem to be "the same as I had last time you gave me an antibiotic, Doc". Seek out, and stay with, a doctor whose judgement you trust and believe them if he or she advises you to try treating your viral infection without antibiotics. That may just turn out to be a big step down the path to improved health and well-being.

Charles H. Booras, MD

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