Before asking your doctor for antibiotics, here’s a general breakdown of common viral vs. bacterial infections:

Bacterial Infections

(ex: strep throat, bacterial pneumonia, bacterial sinusitis)

  • Symptoms: High fevers that persist for several days with dark, thick, yellow phlegm or mucus; strep throat causes severe sore throat, swollen glands, fevers but usually lacks cough and congestion.
  • Prevention: Pneumonia vaccines when indicated; hand hygiene; disinfect common household surfaces.
  • Medication management: Antibiotics prescribed by a trained medical professional; evaluation by your health care provider is strongly recommended.

Viral Infections

Flu

  • Symptoms: Fevers, cough, sore throat, congestion, sinus pressure, body aches, fatigue.
  • Prevention: Flu vaccine (recommended for all ages six months and older); hand hygiene; cough etiquette; disinfect common household surfaces.
  • Medication management: Flu can be treated with antivirals prescribed by your medical provider when indicated; otherwise, as with most other viral infections listed below, rest, decongestants, fluids and anti-inflammatory medications are helpful.

Bronchitis

  • Symptoms: Cough with or without mucus production, fatigue, mild headache and/or body aches.
  • Prevention: Hand hygiene; cough etiquette; disinfect common household surfaces.
  • Medication management: Rest, decongestants, fluids and anti-inflammatory medication. If you have a fever greater than 100.4 degrees Fahrenheit, or symptoms lasting longer than three weeks, seek medical attention.

Common Cold and Sinusitis

  • Symptoms: Sneezing, congestion, sinus headache, some sore throat or post nasal drip. These can last more than 10 days.
  • Prevention: Hand hygiene; cough etiquette; disinfect common household surfaces.
  • Medication management: Rest, decongestants, fluids and anti-inflammatory medications. If symptoms last more than 10 days without improvement, or are more severe than usual with persistent high fevers, seek medical attention as you may have developed a bacterial sinusitis after your initial viral infection.

Viral Sore Throat

  • Symptoms: Sneezing, coughing, runny nose and fevers less than 101 degrees Fahrenheit.
  • Prevention: Hand hygiene; cough etiquette; disinfect common household surfaces.
  • Medication management: Rest, decongestants, fluids and anti-inflammatory medications. If you have a high, persistent fever, a rash or symptoms lasting longer than a week, or if you develop difficulty swallowing or breathing, seek medical attention for a potential bacterial process.

How do I tell the difference between an allergy and a cold?

If you tend to get “colds” that develop suddenly and occur at the same time every year, it’s possible that you actually have seasonal allergies. Although colds and seasonal allergies may share some of the same symptoms, they are very different diseases.

Common colds are caused by viruses, while seasonal allergies are immune system responses triggered by exposure to allergens, such as seasonal tree or grass pollens.

Treatment of a common cold may include rest, pain relievers and over-the-counter cold remedies, such as decongestants. A cold usually lasts three to 10 days, although some may last as long as two or three weeks. A common cold does not need antibiotics.

Treatment of seasonal allergies may include over-the-counter or prescription antihistamines, nasal steroid sprays and decongestants, and avoidance of exposure to allergens where possible. Seasonal allergies may last several weeks.

Symptom check: Is it a cold or allergy?

Symptom

Cold

Allergy

Cough

Usually

Sometimes

General aches and pains

Sometimes

Never

Fatigue and weakness

Sometimes

Sometimes

Itchy eyes

Rarely

Usually

Sneezing

Usually

Usually

Sore throat

Usually

Rarely

Runny nose

Usually

Usually

Stuffy nose

Usually

Usually

Fever

Sometimes

Never


Cold remedies: What works, what doesn’t, what can’t hurt

Cold remedies are almost as common as the common cold, but are they effective? Nothing can cure a cold, but there are some remedies that might help ease your symptoms and keep you from feeling so miserable. Here’s a look at some common cold remedies for adults and what’s known about them.

Cold remedies that work

If you catch a cold, you can expect to be sick for one to two weeks. That doesn’t mean you have to be miserable. Besides getting enough rest, these remedies might help you feel better:

  • Stay hydrated. Water, juice, clear broth or warm lemon water with honey helps loosen congestion and prevents dehydration. Avoid alcohol, coffee and caffeinated sodas, which can make dehydration worse.
  • Your body needs to heal.
  • Soothe a sore throat. A saltwater gargle — 1/4 to 1/2 teaspoon salt dissolved in an 8-ounce glass of warm water — can temporarily relieve a sore or scratchy throat. You can also try ice chips, sore throat sprays, lozenges or hard candy.
  • Combat stuffiness. Over-the-counter saline nasal drops and sprays can help relieve stuffiness and congestion.
  • Relieve pain. Adults can take acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or aspirin. Based upon your medical history, your provider will advise which over the counter choice is best for you.
  • Sip warm liquids. A cold remedy used in many cultures, taking in warm liquids, such as chicken soup, tea or warm apple juice, might be soothing and might ease congestion by increasing mucus flow.
  • Add moisture to the air. A cool-mist vaporizer or humidifier can add moisture to your home, which might help loosen congestion. Change the water daily, and clean the unit according to the manufacturer’s instructions.
  • Try over-the-counter (OTC) cold and cough medications. For adults, OTC decongestants, antihistamines and pain relievers might offer some symptom relief. However, they won’t prevent a cold or shorten its duration, and most have some side effects. Take medications only as directed. Some cold remedies contain multiple ingredients, such as a decongestant plus a pain reliever, so read the labels of cold medications you take to make sure you’re not taking too much of any medication.

Cold remedy that does not work

The list of ineffective cold remedies is long. The most common one that does not work:

  • These attack bacteria, but they’re no help against cold viruses. Avoid asking your doctor for antibiotics for a cold or using old antibiotics you have on hand. You won’t get well any faster, and inappropriate use of antibiotics contributes to the serious and growing problem of antibiotic-resistant bacteria.

Cold remedies with conflicting evidence

In spite of ongoing studies, the scientific jury is still out on some popular cold remedies, such as vitamin C and echinacea. Here’s an update on some common alternative remedies:

  • Vitamin C. It appears that for the most part taking vitamin C won’t help the average person prevent colds. However, taking vitamin C before the onset of cold symptoms may shorten the duration of symptoms. Vitamin C may provide benefit for people at high risk of colds due to frequent exposure.
  • Study results on whether echinacea prevents or shortens colds are mixed. Some studies show no benefit. Others show some reduction in the severity and duration of cold symptoms when taken in the early stages of a cold. Different types of echinacea used in different studies may have contributed to the differing results.

Echinacea seems to be most effective if you take it when you notice cold symptoms and continue it for seven to 10 days. It appears to be safe for healthy adults, but it can interact with many drugs. Check with your doctor before taking echinacea or any other supplement.

  • There’s been a lot of talk about taking zinc for colds ever since a 1984 study showed that zinc supplements kept people from getting as sick. Since then, research has turned up mixed results about zinc and colds.

Some studies show that zinc lozenges or syrup reduce the length of a cold by one day, especially when taken within 24 hours of the first signs and symptoms of a cold.

Zinc also has potentially harmful side effects. Talk to your doctor before considering the use of zinc to prevent or reduce the length of colds.

Take care of yourself

Although usually minor, colds can make you feel miserable. It’s tempting to try the latest remedy, but the best thing you can do is take care of yourself. Rest, drink fluids and keep the air around you moist. Remember to wash your hands frequently.


Cough, Cold or the Flu? Know When Antibiotics Work for You

By Priya Nori, M.D. and Jaimie Mittal, M.D. Feb. 20, 2018

Recently, I visited my 75-year-old grandmother, who was suffering from cough and cold symptoms. She had similar symptoms last year and was prescribed a course of antibiotics by her doctor. Ultimately, she felt better, either due to antibiotics or to time and rest, but it’s hard to know for sure which was most helpful. This year, she experienced cough and cold symptoms again and went to her doctor expecting another antibiotic prescription for this episode. However, the doctor felt that she most likely had a viral infection and therefore didn’t need antibiotics.

Since my grandmother can be very persistent, the doctor ultimately did prescribe antibiotics again. My grandmother improved, but about three weeks later she developed severe diarrhea and was admitted to the hospital for dehydration and kidney failure. Doctors diagnosed her with an intestinal infection due to bacteria called Clostridium difficile, a condition associated with antibiotic use. To treat this infection, my grandmother required a two-week prescription of a new antibiotic. Today, she says she has not felt the same since her intestinal infection. In her age group, she’s lucky to have survived.

According to the Centers for Disease Control and Prevention, up to 30 percent of antibiotics prescribed for outpatients are unnecessary. Most of these prescriptions are for short-term respiratory illnesses, which are often caused by viruses and don’t respond to antibiotics. Although considered miracle drugs when first discovered last century, antibiotics are not harmless. Antibiotics are necessary and potentially lifesaving for serious bacterial infections (like pneumonia or meningitis); however, they can also cause serious consequences, as in my grandmother’s case. Studies show that antibiotics, in general, cause 1 in every 5 emergency department visits due to rashes, allergic reactions and diarrhea.

To avoid incorrect antibiotic use, let’s review when antibiotics work and when they don’t, and what you can do to prevent viral infections.

Most upper respiratory infections can involve mucus production, fatigue, headaches, body aches, congestion and a cough. During this time, it’s most helpful to get a lot of rest and maintain your fluid intake. Using a humidifier or breathing in steam during a hot shower can help keep your throat from drying out. Lozenges and other over-the-counter cough suppressants can help soothe your throat from persistent coughing. You should contact your doctor if you have persistent fevers for three or more days over 100.4 degrees Fahrenheit (38 degrees Celsius), shortness of breath or if your symptoms last longer than 10 days for most conditions. If your condition continues to worsen and/or is persistent, your physician may obtain an x-ray or recommend antibiotics and/or other treatments, such as inhalers.

Despite rest and over-the-counter remedies, viral infections can sometimes predispose people to bacterial infections. However, taking antibiotics when you have a viral infection doesn’t prevent this complication or shorten your duration of symptoms. Vaccines, such as those against influenza or pneumonia, are crucial for preventing severe illness and controlling wide-spread disease in the public. Talk to your doctor to make sure you’re up-to-date with recommended vaccines.

The flu shot is recommended for everyone over the age of 6 months and is widely available through your doctor, local pharmacy and perhaps your employer.

For viral infections that don’t have vaccines available, practice preventive measures to deter viruses from causing infection. These measures include: using “cough etiquette,” (i.e. covering your mouth when coughing or sneezing, coughing into the fold of your arm instead of into your hands), washing your hands often with soap and warm water, using alcohol-based waterless soap, avoiding shaking hands with others when you’re ill and disinfecting common household surfaces. Viruses can spread in respiratory droplets through the air and live for up to a few hours on household surfaces. Common household cleaning agents can disinfect smart phones, laptops, tablets, tabletops, countertops, doorknobs and other common surfaces.

If you plan to visit your doctor for persistent or severe symptoms, make sure to set goals for the visit. Come prepared to discuss your symptoms, treatments and preventive measures. Don’t expect to receive an antibiotic prescription unless you really need one for a potential bacterial infection. Also, make sure to develop a follow-up plan with your doctor – know whom to call and what to do for worsening symptoms. Sites like conversationsforhealth.com can help you prepare your questions and possible treatment plans.

Understanding the above and practicing infection prevention are your best defenses during cold and flu season. Proper antibiotic management can protect you from unnecessary and unwanted complications.

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