Why No Antibiotic?

Viral infections

Many common infections of the nose, throat, sinuses, ears, and chest are caused by viruses. Flu-like illnesses are also caused by viruses. Diarrhoea and/or vomiting are often due to a viral infection of the gut. If you are normally well, your immune (defence) system is good at fighting off many types of viral infection. An antibiotic is not needed if a virus is causing an infection. This is because:

• Antibiotics do not kill viruses. Antibiotics only kill bacteria.
• Antibiotics may cause side-effects such as diarrhoea, rashes, feeling sick, etc.
• Overuse of antibiotics when they have not been necessary has led to some bacteria becoming resistant to them. This means that some antibiotics might not be as effective when they are really needed.

You may feel unwell for several days or more until a viral infection clears. Treatment aims to ease symptoms. Treatments that are commonly advised for viral infections include the following.

• Paracetamol or ibuprofen to reduce a high temperature (fever), and to ease aches, pains, and headaches.
• Make sure you drink enough to prevent mild dehydration. Dehydration may develop if you have a high temperature, and it can make a headache and tiredness much worse.
• Do not wrap up, but try to cool down if you have a high temperature. This is particularly important in children. If a child has a high temperature, then take their clothes off (in a warm, but not hot, room) and consider giving some paracetamol or ibuprofen.
• Other advice may be given for specific symptoms. For example, decongestants for a blocked nose, etc. Ask a pharmacist for advice.

What about bacterial infections?

The immune system can clear most bacterial infections. For example, antibiotics usually do little to speed up recovery of bronchitis, or most ear, nose, and throat infections that are caused by bacteria. However, you do need antibiotics if you have certain serious infections caused by bacteria, such as meningitis or pneumonia. When you are ill, doctors are skilled at checking you over to rule out serious illness, and to advise if an antibiotic is needed.

What if symptoms change?

Occasionally, a viral infection or minor bacterial infection develops into a more serious infection. See a doctor to review the situation if the illness appears to change, becomes worse, does not go after a few days, or if you are worried about any new symptom that develops.

References

• Antimicrobial Resistance, Health Protection Agency (2007)
• Antibiotic resistance. Department of Health. Various documents, various dates.
• Antimicrobial Resistance. European Centre for Disease Prevention and Control. Various documents, various dates.