Cold Hard Facts

Pill Box: Antibiotics aren't always the answer

click to enlarge John R. White chairs WSU-Spokane's Department of Pharmacotherapy.
John R. White chairs WSU-Spokane's Department of Pharmacotherapy.

I went to my doctor last week with a cough and runny nose that had been going on for about a week. I was hoping to get some antibiotics, but the doctor only gave me a recommendation for some OTC cough medicine and a decongestant. Why didn't she just give me the antibiotics?

Well, first of all, kudos to your doctor. She almost certainly made the right decision. It sounds like you have a simple and uncomplicated cold. Antibiotics are very useful for bacterial infections (such as some types of pneumonia) but do not have an impact on viral infections such as the common cold. As the old adage says, "A cold will go away in two weeks if you see your doctor, and in 14 days if you don't."

Not only that, but antibiotics are not benign, and taking them can at times cause complications. First, exposure to an antibiotic could result in an allergic reaction. These can range from being mild to life-threatening. It is not prudent to take this chance if there is not a likely strong benefit.

Second, every time any of us takes an antibiotic we expose the many types of bacteria in our bodies (good and bad) to it, and this exposure can facilitate the development of resistance to the antibiotic by those bacteria.

Third, we are learning more and more about our normal microbiome — the many non-disease-causing and helpful bacteria that live in and on our bodies and their functions. When we give antibiotics we wipe out both good and bad (if they are present) bacteria, and this can lead to problems. One example is a very severe form of diarrhea that can be caused by the overgrowth of a problematic bacteria after antibiotic therapy has wiped out the normal populations.

So hang in there and expect to get better soon. If you get worse or develop a fever, go back to your provider again.

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