Wait before taking that Z-pack!

The flu season is heading straight towards us. I was taught that it takes a week to get over a cold or you can take cold medicine and it will only take 7 days. The symptoms can be alleviated, but the cold will go on. Antibiotics like a Z-pack won’t do any good because a cold is a virus. I thought the flu was bacterial and would respond to antibiotics but I was wrong — most of the time the flu is a virus also.

I asked my doctor, Eileen Hoffman, MD, (and Clinical Associate Professor, Dept. of Medicine at NYU Langone Center) what the deal was. She told me that she just finished a course at Harvard on Infectious Diseases in Primary Care. “The bottom line is most things don’t require antibiotics — especially respiratory ones: Green phlegm can be seen in viral infections and doesn’t mean it’s bacterial and requires antibiotics.” The Harvard course recommended waiting 2 WEEKS before using antibiotics to treat a cough.

There are exceptions, Dr. Hoffman noted. Community acquired pneumonia is different and is usually best diagnosed with a physical exam and chest x-ray. “They also recommended using older antibiotics as they have better response and less adverse events,” she added.

There are good reasons to avoid using antibiotics unless definitely needed. Side effects include diarrhea and vomiting; either can cause dehydration which is much more life-threatening than a cold. Antibiotic resistance is a very real concern. The term is a bit of a misnomer. It’s not that you develop a resistance to antibiotics, instead the bacteria in your body grows stronger than the typical antibiotic can manage.

Dr. Hoffman said, “More worrisome than antibiotic resistance is MRSA [methicillin-resistant Staphylococcus aureus] which is epidemic now in the overuse of antibiotics.”

So get your flu shot, stock up on cough drops. But don’t pressure your doctor into giving you antibiotics for the flu. Save the big guns so that they will work when you need them.

Suzanne B. Robotti

Suzanne Robotti founded MedShadow Foundation in 2012. Learn more about Su and her mission.

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