By Mollie Cecil, MD

Dr. Mollie Cecil

You’re not feeling well. You’re coughing, or you have a runny nose and a lot of sinus pressure. Maybe you have a very sore throat that feels a lot like strep throat. Surely, you must have an infection, so you head to your primary care doctor’s office for an evaluation. But, your doctor doesn’t give you an antibiotic and instead sends you home with instructions for self-care. Why is that?

Why do we use antibiotics?
Most infections in your body are caused by either bacteria or viruses, but viral infections are much more common. Antibiotics are only effective against bacteria and do not work against other germs. Without antibiotics, many common bacterial illnesses could cause severe illness or even death.

What’s the harm in using antibiotics if it’s a viral infection?
All medications have side effects and potential complications, and so we never want to use a medication unless it is necessary. Antibiotics can cause problems, such as yeast infections, thrush, or a severe gastrointestinal illness called C. diff colitis that causes bloody diarrhea, severe abdominal pain, and weight loss.

We also want to make sure antibiotics stay effective. Bacteria are constantly evolving, and exposing bacteria to antibiotics too frequently can allow the bacteria to become resistant to the antibiotic. When this happens, the antibiotic no longer works against that particular strain of bacteria. Antibiotic resistance is becoming an increasing problem around the world, and there are even some bacteria now that don’t respond to any antibiotics and are very deadly as a result. The most important way to prevent antibiotic resistance is by making sure that we use antibiotics appropriately and only when treating a bacterial infection.

What conditions are usually caused by viruses?
Bronchitis, pharyngitis in adults, and sinusitis are usually caused by viruses and do not need to be treated with antibiotics. Bronchitis is caused by a virus 94 percent of the time. Viruses also cause most pharyngitis in adults, so true strep throat caused by streptococcus bacteria is uncommon.

Sinusitis is much more frequently caused by viruses. In fact, sinusitis is only caused by bacteria about two percent of the time. The American Academy of Otolaryngology advises that we do not use antibiotics in patients with sinus infections unless they have been sick for at least 10 days. Most sinusitis caused by allergies or viruses will clear up on its own by then, so if you have symptoms of a sinus infection that last longer than this, you are more likely to have a bacterial infection and need an antibiotic.

What can I do to feel better if I have a virus?
Your body will eventually clear the virus on its own, and by taking good care of yourself, you’ll enable your body to do this quicker. Get plenty of rest, stay hydrated, and eat a healthy diet to help your body fight off the infection.

Washing your hands frequently is the most effective way to prevent infection and reduce spreading it to others. In addition to self-care, make sure that you and your family are practicing good hygiene habits.

Nobody likes being sick, and we all want to get better as soon as possible. By only using antibiotics when it’s appropriate, your doctor can help prevent complications from antibiotics and ensure that our current antibiotics continue to work against fighting off bacteria.

Learn more: Take the Antibiotics Quiz