Why Won't My Doctor Just Give Me Antibiotics To Treat A Cold Or The Flu?

— -- Question: Why Won't My Doctor Just Give Me Antibiotics To Treat A Cold Or The Flu?

Answer: You don't want to have anyone give you antibiotics for colds or flu, and you don't want to take them. The reasons are pretty clear cut. Antibiotics only work against bacteria, and viruses are what cause colds and flu. In addition, they cause almost all cases of sinusitis, and bronchitis or chest colds are also due to viruses. So antibiotics won't do any good. Some people have had the experience that the cold settles in their chest -- somebody gave them antibiotics and they finally got better.

But in fact if you give people sugar pills or antibiotics for acute bronchitis, they get better at the same speed. So it makes no difference whether you take antibiotics or not.

So why not just try them? Well the reason is that like any powerful medicines antibiotics can actually cause harm. And in this case, it can cause harm two ways. You can have bad effects from the antibiotic itself, you can get diarrhea, you can develop rashes. One type of diarrhea called clostridium difficile can be life threatening. In fact, rashes are common enough, and side effects are common enough with antibiotics, that about one in a thousand people who takes an antibiotic will end up in an emergency room for a side effect.

Now if it was going to do some good, that would of course be fine. But it does no good in this setting. The other reason, and one that makes more sense to us as infectious disease doctors, is resistance. If you take antibiotics for settings where they aren't doing any good, then the bacteria that you carry in your nose and throat become resistant to those antibiotics and may not do any good when you need them in the future. And those resistant bacteria may spread around the community, and antibiotics may do less good for serious infections in the future.

So above all you want to know when to say no to antibiotics, and that's for colds, flu, bronchitis, and most sinusitis.

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