Hint: It's probably not as often as you think, say our experts.

If there's one feeling we all know well, it's that foreboding sense that a cold is coming—that dull soreness in your throat and the sudden congestion that makes breathing through your nose out of the question. According to the Centers for Disease Control, the common cold is actually the top reason why adults miss work and kids stay home from school. But even though it's so, well, common, the symptoms can be quite debilitating—and over-the-counter cold remedies and nasal decongestants only offer temporary relief. By the time you've reached day three, you might feel justified asking your doctor to write a prescription for an antibiotic. In reality, though, an antibiotic is far from a universal solution. Here, two experts—Dr. Sing Sing Way, professor of pediatrics at Cincinnati Children's Hospital Medical Center, and Laura Piddock, director of scientific affairs at the Global Antibiotic Research & Development Partnership—walk us through the most common medical conundrum: To antibiotic or not to antibiotic?

Give It Time

Most colds will resolve themselves in a few days if you practice some general self-care. That is, drink lots of fluids, eat a nutrient-rich diet high in fruits and vegetables, and get at least eight hours of sleep a night. "Many people go to a doctor looking for a quick fix, so that they can continue to go about their busy lives," says Piddock, "so they're asking for antibiotics. But these are medicines that are crucially important to our healthcare system and should really only be used when needed." Taking antibiotics when they're not necessary contributes to the growth of drug-resistant superbugs. "It's a numbers game," Piddock explains. "The more antibiotics are used, the bigger the likelihood that they'll become ineffective against the bugs that they're supposed to be fighting." This has become a serious issue among populations with weakened immune systems—like newborns and cancer patients—who rely on antibiotics to work at maximum strength in order to bounce back from life-threatening infections.

Woman sitting in living room blowing nose
Credit: Getty / Westend61

Consider the Source  

"We're susceptible to all sorts of illnesses caused by a variety of pathogens, and many of those pathogens trigger the same cough, runny nose, congestion, or fever," says Dr. Way. In some cases, a bacterium may be to blame—and an antibiotic may be just the thing to kill it; but in the vast majority of cases, a virus is the culprit. And antibiotics don't have any power over those. If your symptoms feel severe, or you've given yourself a few days to recover and you still feel just as sick, pay a visit to your doctor. "He or she is best equipped to make the call as to whether a bacterium or a virus is at the root of your condition," says Dr. Way. Beyond analyzing your constellation of symptoms, your doctor will also do some testing to rule out illnesses like the flu and strep throat, which warrant specific medications.

Listen to Your Doctor

Your physician has seen many a cold first-hand and knows the different ways they can present themselves. As a result, he or she is most qualified to decipher the nuances of your symptoms and diagnose accordingly. On your first visit (especially if it's just a day or two after the onset of your symptoms), your doctor likely won't prescribe an antibiotic. It's common practice to see if a cold will clear up on its own beforehand—not just to avoid contributing to the problem of drug resistance, but also because of antibiotics' side effects. Our microbiomes consist of a bunch of good, infection-fighting bacteria, and antibiotics typically knock them out in their wake. Ultimately, it's worth waiting to see if you really need one before charging ahead—and killing the good with the bad.

If your doctor decides that you don't need an antibiotic (or, at least, not yet), it doesn't mean that he or she isn't treating you, says Dr. Way: "It just means that they think you have an infection caused by a pathogen against which an antibiotic simply wouldn't be effective." And in that case, it's clear why the risks of taking one could outweigh the benefits.


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