“I have a cold; can you call in a z-pack for me!”

Patients frequently ask about antibiotics, but before prescribing them, it’s important to consider whether they are truly indicated for the infection at hand.

In the majority of cases, when you have a cold, it is likely of viral in nature and does not require antibiotic treatment. These colds are often self-limiting, which means that your body/immune system will take care of the infection if you allow your body the time to heal. Rest and fluids are the hallmark of therapy for a cold. Additionally, incorporating an antipyretic like Tylenol or Advil can help alleviate symptoms such as fever and body aches.

We know that antibiotics treat bacterial infections and don’t work if you have a virus. So, how can we tell if what you have is bacterial or viral?

Bacteria are intricate, single-celled organisms, often have a firm cell wall and a flexible, membranous layer enveloping the inner cell fluid. Their resilience is evident in their adaptability to various environments, ranging from extreme heat and cold to radioactive waste and the human body. Fewer than 1% of bacteria cause diseases and most actually help digest food, destroy microbes which cause diseases, and even provide nutrients.

Viruses, on the other hand, are much smaller. Made up of a protein coat and a core of genetic material, either RNA or DNA, viruses differ from bacteria in their inability to survive independently. Viruses depend on a host for survival, and reproduce by attaching themselves to cells. Typically, they reprogram these cells to generate new viruses.

Some common bacterial infections that require antibiotics are:

  • E. coli Infection
  • Strep Throat
  • Urinary Tract Infections (UTI)
  • Whooping Cough
  • Pneumonia
  • Sepsis

If the infection is in the urine (UTI), blood stream (sepsis), lungs (pneumonia) or in the skin (impetigo or boil) than it is more likely to be bacterial in nature but if you have a cold (upper respiratory infection, sore throat or runny nose) it is more likely to be viral.

When unsure about your condition, it’s best to seek guidance from your physician for an accurate diagnosis. A throat culture or nasal swab may be conducted to aid in the decision of whether antibiotics are necessary. Look out for persistent symptoms like a prolonged fever, a productive cough, severe throat pain, swollen tonsils, or symptoms that don’t improve within a few days, as these could suggest a bacterial infection requiring antibiotic treatment. Certain viral infections can be addressed with antiviral medications such as Tamiflu for the flu, Paxlovid for COVID-19, and Acyclovir for herpes. Rapid testing kits are available for each of these infections, facilitating a swift diagnosis and enabling the initiation of treatment at the onset of symptoms, which consistently yields optimal results.

Don’t hesitate to reach out to your doctor if you’re unwell, your condition worsens, or if symptoms persist for more than a few days, as this could indicate a bacterial infection. However, understand that not receiving an antibiotic for every cold is not uncommon, as it may not always be necessary.

Dr. Lenny Sukienik is a proud member of the TopLine MD Alliance practicing Primary Care in Palm Beach County.

The TopLine MD Alliance is an association of independent physicians and medical practice groups who are committed to providing a higher standard of healthcare services. The members of the TopLine MD Alliance have no legal or financial relationship with one another. The TopLine MD Alliance brand has no formal corporate, financial or legal ties to any of the affiliated physicians or practice groups.