How to Know When You Really Need Antibiotics
If you have a cough or cold, getting a packet of pills from your doctor won’t help if your infection is caused by a virus. Many antibiotic prescriptions are unnecessary (up to 80% by some estimates ), so how do you know when a prescription might help you?
Taking antibiotics when you don’t need them can put you at risk for side effects that range from annoying to, in rare cases, life-threatening. For example, they kill some of your body’s “good bacteria”, which leads to yeast infections and diarrhea. They also increase the likelihood that any future infections you get will be antibiotic resistant, so it’s best to save your medications for when you really need them.
This Consumer Reports Health fact sheet lists the recommendations of ten different medical associations on when antibiotics are recommended and when not. A few highlights:
- According to the American Academy of Allergy, Asthma, and Immunology, sinus infections are almost always viral and tend to go away on their own, even in the rare cases when they are bacterial. If the infection lasts more than ten days, gets better, and then worsens again, or causes fever and thick colored mucus for three days in a row, then antibiotics may be needed.
- For children with a cough or runny nose, the American Academy of Pediatrics notes that colds are viral, bronchitis is usually either viral or comes from an irritant such as cigarette smoke, and if a doctor suspects a bacterial infection such as sore throat, they should get it tested. … before writing a recipe. Otherwise, antibiotics are not recommended for coughing unless it lasts more than two weeks.
The list also includes recommendations for ear infections in children, urinary tract infections in the elderly, skin infections, and surgical wounds.
This set of CDC guidelines for adults with coughs is more technical in nature but provides detailed information. Here’s some bad news if you were hoping to just drop in for a z-pak:
Routine antibiotic treatment for uncomplicated bronchitis is not recommended, regardless of the duration of the cough.
and
Antibiotic treatment for nonspecific upper respiratory tract infections in adults does not resolve the disease and does not prevent complications and is therefore not recommended.
Your doctor will try to rule out pneumonia and whooping cough (whooping cough), but if you don’t have them, you’re better off just letting your immune system do its job.