Antibiotics are strong medicines that can stop some infections that are caused by bacteria and save lives. But antibiotics can do more harm than good if they are not used properly.

NO! Antibiotics only fight off infections caused by BACTERIA. Antibiotics do not work at all against infections caused by VIRUSES. Viruses cause colds and most coughs and sore throats.

Whenever you use an antibiotic, sensitive bacteria are killed but resistant ones may be left behind to grow and multiply. Many experts attribute the development of antibiotic resistant bacteria to the overuse and inappropriate use of antibiotics.

First, don't expect antibiotics to cure every illness. Do NOT take antibiotics for colds or flu, which are caused by viruses. Most viral illnesses just need to run their course. Sometimes, this can take 2 weeks or more. Contact your doctor if any symptoms are persisting longer than 7-10 days, or sooner, if your symptoms are getting worse.

The answer depends on what is causing your infection:

• COLDS AND FLU: These illnesses are caused by viruses. Antibiotics are NOT helpful.
• COUGH/Bronchitis: Most of these illnesses are caused by viruses but they can occasionally be caused by bacteria. Nevertheless, unless you have a serious medical condition (for example, asthma or emphysema), it is usually best to wait it out even it turns out that your infection is caused by a bacteria.
• SORE THROAT: Again, most sore throats are caused by viruses. "Strep" throat is caused by a bacteria but this infection can be rapidly detected by a throat swab done in your physician's office. If strep throat is present, an antibiotic can be started immediately.
• EAR INFECTIONS: If there is an infection in the middle ear detected when your physician examines your ear, then antibiotics should be provided. Bacteria are the most likely cause of ear infections
• SINUS INFECTIONS: Antibiotics should be reserved for those infections that last more than 2 weeks.

Basically, referring to the bullets outlined above should help in determining if the infection is most likely bacterial or viral. Admittedly, there is some judgment involved. If you are not certain, your physician may be able to help. The physician will use his or her best judgment in trying to discern whether your infection is bacterial or viral. Even if a viral infection is suspected and later, it turns out you have a bacterial infection, you can receive an antibiotic at that time. If your doctor suspects a viral infection and your symptoms do not improve after 7-10 days, you should be reevaluated. If your symptoms are getting progressively worse, you should be seen sooner. At this point, many patients become upset with the health care provider, thinking, "If I only got the antibiotic sooner, I would not have had to endure this illness for so long". In response, I offer the following information:

• It is difficult to predict who will get better without antibiotic and who will benefit from the antibiotics. It is clear that antibiotics do not help viral infections. Unfortunately, a person with a bacterial infection and a person with a viral infection will frequently have the similar symptoms.
• Other than perhaps a longer period of time with symptoms, there is usually no harm done by holding antibiotics until symptoms have persisted for at least 10 days.
• Antibiotics can cause serious medical problems (allergic reactions, more serious infections, nausea, abdominal pain, interactions with other drugs), not to mention the problem with promotion of bacterial resistance to antibiotics.

Just because your symptoms are caused by a virus does not mean that there is nothing to do for your symptoms. Antibiotics will not do any good and could very well do some harm. However, you may find the following measures helpful:

• For fever and general aches and pains associated with a viral infection, ACETAMINOPHEN (Tylenol^®) is the preferred agent.
• For blocked nasal passages, nasal discharge and post nasal drip, a combination decongestant/antihistamine is best.
• For thick, "hard to get out" phlegm, an expectorant like guaifenesin (Robitussin^®) is helpful.
• For an irritating, nagging cough, dextromethorphan is a good cough suppressant. Frequently, products containing this ingredient have a suffix -DM.

We hope you find this information helpful. Remember, please contact your health care provider if your symptoms are getting worse. Working together, we can improve the growing problem of infections caused by bacteria that are resistant to antibiotics.