It’s Friday afternoon. You have been fighting a cold for the past 3 days –runny nose, aching muscles, exhaustion, sore throat. You have fun dinner plans this weekend and are really hoping to feel better. Maybe a course of antibiotics is in order?
Not so fast. Antibiotic overuse is a hot topic in healthcare. Based on a study in the Journal of the American Medical Association (JAMA) in May 2016, the annual antibiotic prescribing rate in 2010 was estimated to be 500 prescriptions per 1000 people. One third of these were deemed inappropriate. This means 1/3 of these people received antibiotics for a condition that would have resolved without treatment.
Why is this a problem? Antibiotic overuse can lead to the development of bacteria that are resistant to commonly used antibiotics, aka superbugs. The most recent “superbug” was the culprit of a urinary tract infection in a woman in Pennsylvania- a strain of E. coli resistant to the antibiotic, colistin, a powerful medication often used to treat critically ill patients in the ICU. For more information, see this article in the Washington Post. If this is left unchecked, we will soon be trying to treat infections for which there is no known cure.
Both doctors and patients are instrumental in the fight to prevent superbug development. Doctors must make well-informed decisions about when antibiotics are necessary in a patient’s care. Patients must be educated on when it is best to seek treatment with antibiotics.
So how do you know when you really need antibiotics?
We use antibiotics to treat bacterial infections. Antibiotics do not treat viral infections. This is important to remember because the common cold, most sinus infections and even most cases of bronchitis are caused by viruses. I am going to discuss each of these ailments, their treatments, and when to think about calling your doctor.
Common Cold
Symptoms include a runny nose, nasal congestion, sore throat, headache, tiredness, and low grade fever. There is no specific treatment for colds. Antibiotics are not effective since colds are caused by viruses. Rest and hydration can help make you more comfortable. Symptoms can last 7-10 days. There are a multitude of over-the-counter cold medications available. Check with your doctor or pharmacist before taking these.
Sinus Infection
This is an infection of the sinus passages. Symptoms include nasal congestion, green or yellow drainage from the nose, pressure or pain in your face, head, or behind your eyes. It is important to note that the color of drainage does not indicate whether the infection is viral or bacterial. Sinus infections are caused mostly by viruses. The treatment is similar to that of a cold- rest, hydration, and the tincture of time. Neti pots can help with symptoms as well.
Bronchitis
Bronchitis occurs when the airways in the lungs are inflamed and filled with thick mucus. Symptoms include productive cough, low grade fever, and mild body aches. Bronchitis is usually caused by a viral infection. Thus, treatment is similar: rest and hydration. Talk with your doctor about what over-the-counter medications are safe to take. Your doctor might prescribe cough medication as well.
For many people, these illnesses may not require a visit to the doctor. However, certain symptoms could be indicative of a more serious medical problem.
When to seek medical attention:
- If your symptoms last longer than 10 days- it is possible to develop a secondary infection with a bacteria requiring antibiotics.
- If you have high fevers (>101 F). Low grade fevers (100 F- 101 F) can occur with viral infections, but higher fevers suggest a more serious infection or medical problem.
- If you feel short of breath or are wheezing. This could be indicative of pneumonia.
- If you have a fever plus a cough with thick or bloody mucus.
- If your symptoms improve then worsen again. This often means a bacterial infection followed a viral infection.
Do not hesitate to call your physician’s office with any concerns or questions about symptoms.
