When Is the Right Time to Use Antibiotics?

When we feel bad, we want to get better quickly. And medicines like antibiotics may seem like the answer when you have a problem like a cough, sore throat or sinus pain.

But studies show that most upper respiratory infections are viral. And antibiotics do not help viral infections. They only fight infections caused by bacteria.

The Centers for Disease Control and Prevention (CDC) warns that taking antibiotics when you have a virus can do more harm than good. You will still feel sick, and the antibiotic could give you a skin rash, diarrhea, a yeast infection or worse.

Antibiotics also give bacteria a chance to become more resistant to them. This can make future infections harder to treat. That means that antibiotics might not work when you really need them. Antibiotic resistance has become a serious problem.

Antibiotics are among the most frequently prescribed drugs in the U.S. The CDC estimates that at least 28 percent of prescriptions for antibiotics are unnecessary or were the wrong treatment. If your doctor prescribes an antibiotic, it’s a good idea to ask questions and make sure you really need it.

When It’s Bacterial

You may need an antibiotic for:

• A sinus infection that doesn’t improve in 10 days, or improves initially and then gets worse
• A sudden-onset illness with a 102-degree fever and colored nasal discharge or mucus or facial pain that lasts for three days in a row or more
• Sudden-onset bacterial pneumonia. Symptoms usually include cough, colored mucus, fever of at least 100.6 degrees, shaking chills, and shortness of breath or chest pain with a deep breath. This illness is frequently confirmed by a chest X-ray.
• A cough with a severe “whooping” sound that comes in episodes or spasms and is so severe it may take your breath away or cause vomiting
• Strep throat documented by a throat swab. Strep throat accounts for about 1 out of 10 cases of sore throats.

The CDC offers more information   about when you may need antibiotics.

When It’s Viral

Some ways to treat minor non-bacterial illnesses include:

• Ibuprofen or acetaminophen for aches and pains
• Cough suppressants, decongestants or antihistamines as needed for symptoms
• Plenty of fluids
• Rest
• Humidifier (humidified air may improve symptoms of nasal congestion and runny nose)

Parents should talk to their children’s health care provider about when and how to treat fever and cough. Please note that for children below age 6, ibuprofen, cough suppressants, decongestants or antihistamines are not recommended because there is no evidence of their effectiveness and they can cause harmful side effects.

Sources: Inappropriate Antibiotic Prescribing for Adults Comes With Increased Risks,   PEW Charitable Trust, 2023; Antibiotic Resistance Project;   PEW Charitable Trust; Antibiotic Prescribing and Use,   CDC, 2021; Treatment for Common Illnesses,   CDC, 2021; Antibiotic resistant bacteria: current situation and treatment options to accelerate the development of a new antimicrobial arsenal,  National Library of Medicine, 2022

Originally published 12/16/2019; Revised 2023