We are now coming into the season for lots and lots of coughs and colds.  Even without the complication of the new novel H1N1 virus, this time of year and through the winter months, we see so many patients coming in with coughs or colds.  Here, I will not be addressing the H1N1 viral infection since there are guidelines for treatment with an anti-viral medication (Tamiflu) if your doctor suspects that you have this virus.  The rest of the post does not relate to the H1N1 infection but the infection of other viruses related to the common cold, bronchitis, or sinusitis.

For this post, I’m just going to give some information on the use of antibiotics for many upper respiratory infections.  Some patients or parents of sick children will often want an antibiotic prescribed for symptoms that amount to an upper respiratory infection (URI).  Unfortunately, most of these are caused by viruses.  The use of antibiotics will not help.  And there are numerous studies out there that have shown that there is no clinical difference in terms of improvement between the group of patients who get the antibiotic versus those who get placebo.  Furthermore, the symptoms of fevers or color of the sputum or nasal discharge do not correlate with a viral or bacterial cause of the illness.  This means that if you or your child has a fever, a productive cough or nasal discharge that is described as yellow or green or brown, this will not aid the doctor in distinguishing whether the infection is caused by a bacteria or virus.  The majority of causes are viral and the symptoms are no different.

For prolonged coughs, defined as more than 10 days, the use of an antibiotic may be indicated.  This will probably depend on the doctor’s evaluation.  If Pertussis is suspected, the doctor will prescribed antibiotic treatment.  Or if the patient has clinical signs of pneumonia, the doctor may treat with an antibiotic.  However, bronchitis or sinusitis is usually a viral illness and will get better without a course of antibiotics.  For prolonged symptoms, the doctor will decide if a course of antibiotics is necessary.

Obviously we don’t want to be using antibiotics unnecessarily and add to the problem of antibiotic resistance and superbugs.  Talk to your doctor about your concerns and trust that when indicated, your doctor will not withhold an antibiotic prescription.

Tags: Antibiotic, Antibiotic resistance, bronchitis, common cold, Pneumonia, Sinusitis