We are amidst the cold and flu season, and the expectation for antibiotics is so common that I find myself spending most of my time explaining why antibiotic use for colds are inappropriate. It’s time that I feel people would benefit from resting at home, letting their bodies recover. Sometimes I wish I could create a PSA or scream at the top of my lungs that
Colds are caused by a virus! Antibiotics are for bacterial infections. Get some rest, fluids and let your body heal naturally!
(I also have a few choice words for anyone who continues to inappropriately prescribe antibiotics for a cold and perpetuate the unreasonable demand… Should I tell you how I really feel?)
I am absolutely thrilled that the American College of Physicians (ACP) and the U.S. Centers for Disease Control and Prevention (CDC) recently published an article in the Annals of Internal Medicine that gave specific recommendations to physicians for appropriate scenarios to prescribe antibiotics. The article recommended the following valuable guidelines:
- NOT prescribe antibiotics for patients with the common cold. (AND I REPEAT, CLINICIANS SHOULD NOT PRESCRIBE ANTIBIOTICS FOR THE COMMON COLD)
- NOT perform testing or initiate antibiotic therapy in patients with bronchitis unless pneumonia is suspected.
- Test patients with symptoms suggestive of strep throat by rapid antigen detection test and/or culture for group A Streptococcus and should treat patients with antibiotics ONLY if they have confirmed streptococcal pharyngitis.
- Reserve antibiotic treatment for acute rhinosinusitis for patients with:
– persistent symptoms for more than 10 days
– onset of severe symptoms or signs of high fever (>39 °C)
– purulent nasal discharge or facial pain lasting for at least 3 consecutive days
– or onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving (double sickening).
The article also states that sinus infections usually clear up without antibiotics even if bacteria are to blame, and that antibiotics in these cases cause more adverse effects. The guidelines also recommend the following remedies for symptom relief:
Analgesics for pain
Antipyretics for fever
Systemic or topical decongestants
Saline nasal irrigation
Cough suppressants (dextromethorphan or codeine)
First-generation antihistamines (diphenhydramine)
The cold virus will eventually run its course. Often catching a cold happens during times of high stress and lack of sleep, so it’s important to allow yourself to rest.
Antibiotic resistance is a serious health threat and not to be taken lightly. Again, it requires a commitment from both physicians and patients. So save yourself some time and healthy gut bacteria and stay home and rest. Your cold will get better and if not, I’ll be here to help.
Let me know your thoughts in the comments!