Healthy Living

Colds and Flu: Do You Need Antibiotics?

Jan. 5, 2022

COVID-19 has significantly changed the way we consider even minor coughs and cold-like symptoms. UR Medicine Primary Care's Dr. Michael Gavin offers advice on what to look for, when to call to your doctor, and whether or not antibiotics can help.

man sick in bed with thermometer in his mouth

With winter upon us and another rise in COVID cases, we are seeing more and more coughs and colds. COVID-19 has significantly changed the way we consider even minor coughs and cold-like symptoms. To make matters more complicated, we're seeing a return of non-COVID viruses such as RSV, Coxsackie (hand, foot and mouth), as well as stomach viruses. While there is a significant amount of information on the internet, it’s hard to determine what to trust.

Hundreds of different viruses can cause colds. Unfortunately, it’s almost impossible to tell at this time without testing to determine whether someone has COVID, or if they have another viral illness. When in doubt, contact your doctor, or get yourself tested for COVID if you have a fever (temperature of 100°F/38°C) or higher, chills, severe body aches or fatigue, congestion or runny nose, sore throat, loss of taste or smell, cough, shortness of breath, vomiting, or diarrhea. For accurate updates on COVID, I recommend following the Centers for Disease Control and Prevention, the Food and Drug Administration, and the University of Rochester Medical Center webpages.

With all the other viruses going around, it’s important to note that antibiotics have no effect on viral infections. Antibiotics can treat bacterial infections, such as strep throat, a bad skin infection (cellulitis), or a sinus infection.

Besides the fact that they won’t be effective against viruses and may be costly, there’s another good reason for limiting antibiotic use: Taking them when they aren’t needed creates antibiotic resistance.

Antibiotic resistance occurs when bacteria become invincible to antibiotics, making them much harder to treat in the future. Overuse and misuse of antibiotics causes antibiotic-resistant bacteria, or “superbugs.” If more superbugs are created, we will not have any effective antibiotics to treat bacterial infections.

By equipping ourselves with the right information, we can do our best to avoid COVID and the creation of superbugs by appropriately treating non-COVID viral illnesses.

Call your doctor if you’re having any symptoms potentially related to COVID or get tested at a pharmacy or urgent care. Your doctor will direct you on whether you need testing or evaluation. While there are several other viral infections that are going around, it is important to rule out COVID to protect yourself, your family, and those around you.
Take preventative measures to protect yourself against COVID. Avoid crowded indoor events, wear masks in indoor public places, and get vaccinated—and boosted—if you’re eligible and haven’t already.

If you test negative for COVID and still have cold-like symptoms, remember:

Most colds are viral infections. Symptoms of viral infections are cough, runny nose, sore throat, and head and chest congestion. You may also experience low-grade fever (under 100.4°F). Antibiotics are ineffective against these infections. Your symptoms will generally start to improve after seven to 10 days. Over-the-counter medications may help ease your symptoms but will not make the cold go away any faster.
Coughs can last for a while. Coughs after any cold or viral infection (especially after a COVID infection) can last for several weeks, especially for people with asthma or chronic obstructive lung disease (COPD). Talk with your doctor about over-the-counter treatments for this. It’s important to know that over-the-counter medicines to treat coughs are generally not effective in children under the age of 7.
Know when to call your doctor.
- If you’re having trouble breathing, fevers (100.4°F or higher), or sinus pain for more than a week.
- Whenever a baby younger than 2 months of age has a fever, he or she should be evaluated as soon as possible.
A sore throat isn’t always strep throat. But when you also have a fever (temperature of 100.4°F or higher), you should call your doctor.
Stay home if you're sick! If you are negative for COVID, if you have fever, chills, or a significant cough, stay home from work or school.
Take antibiotics correctly. If you do have a bacterial infection and your doctor orders an antibiotic, always finish the entire prescription. Even if you are feeling better, or you think the antibiotic isn’t working, always finish taking the medication as directed. In addition to curing your infection, taking it properly will help prevent antibiotic resistance, and hopefully the development of superbugs.
A little prevention goes a long way. Make sure you are washing your hands frequently, getting enough sleep, and eating healthy. There is good evidence that regular exercise provides some protection against illnesses. Get yourself vaccinated against the flu and COVID if you haven't already (no one wants to isolate and take time from work or school for this, not to mention the potential long-term effects from COVID). If you smoke (or vape), now is a great time to quit. Smoking and vaping can increase your risk of getting COVID, as well as other viral and bacterial infections.