Antibiotics & Viral Infections

Most bugs that infect your eyes, nose, throat, large airways and bowels are viruses, against which antibiotics are powerless. The New York Times ran an article on over-prescription in 2005:

"You've had a cold for five to seven days and thought you were getting better. Then it grew worse. More congestion, increasing fatigue and now headache or facial pain around your nose or eyes or upper teeth. You guessed it was a sinus infection.

Depending on the severity of the symptoms, the doctor's examination and inclinations about treatment, you may be prescribed an antibiotic.

But is this what you need to get better?

Chances are, it is not. Most cases of acute sinusitis are caused by viruses, not bacteria, and taking an antibiotic does nothing more than enrich the pharmaceutical companies and increase the chances of being infected with drug-resistant bacteria.

The average adult catches two or three colds a year, and 0.5 to 2 percent of them are complicated by bacterial infections. In other words, if antibiotics are prescribed for most sinusitis cases, they are most likely being way over-prescribed."

Viruses cause the great majority of respiratory infections: "colds," sinus infections and sinusitis (inflammation of the air-spaces in your skull), bronchitis (inflammation of the largest airways leading to you chest), and sore throats), as opposed to bacteria, which are much less common.

• Bacteria are living creatures: single-celled animals with cell-walls very different from ours, and nuclei using very different life-processes. Because these living things are so different from us, it is easy to make medicines which kill bacteria yet spare humans. These medicines are called ‘antibiotics.'
• Viruses, on the other hand, are infinitely smaller, and are not living things. Instead, they are snippets of DNA in a little envelope, that drift from sneeze to sneeze. When they land in your throat, they slip into your own cells, which begin copying the virus and spitting out new envelopes. The only things to kill here are your cells, making it dangerous and difficult to invent medicines to stop viruses. Instead, this is done efficiently and selectively by your own immune system.

As for the symptoms of viral infections:

• Green or yellow color to your mucous comes from your own infection-fighting cells
• Fever is created by your body as a defense, as it is harder for an infected cell to copy the virus at higher temperatures
• Productive coughs help clear the battlefield of dead cells, infection-fighting mucous, and virus particles coated in antibodies
• Pressure in your face comes as swollen nasal-tissues block the drains for your sinuses, and pressure builds inside

The only way to prove an infection is caused by bacteria is to take a swab and see if anything will grow in a culture. Signs that your infection is more likely to be bacterial are:

• High temperature
• Pain localized to one sinus, or one ear
• Bloody nasal discharge
• Sore throat without cough or runny nose
• Duration of infection longer than 5 days
• Shortness of breath, with rapid breathing and heart-rate

Since antibiotics can do nothing against a virus, giving them when not needed only increases bacterial resistance and can even be harmful to you. Antibiotic-resistant bacteria are frequently in the news, and are a serious problem. This problem was entirely created by physicians being too liberal with antibiotics.

While you're waiting for your own immune system to get you better, here's a copy of our Viral URI Prescription and Viral Gastroenteritis Prescription for your use at home, and a link to an AAFP handout on Viral Respiratory Infections.