It’s flu season — and also common cold season, strep throat season, pneumonia season, bronchitis season, ear infection season, and sinus infection season. In other words, it’s the season of “oh no, am I coming down with something?!”
While the symptoms of each condition may vary, they often share significant overlap. For example, influenza, the common cold, strep and even ear infections can all cause pain in your throat.
Despite the overlap in symptoms, the right treatment varies depending on the illness. An antibiotic may help you heal from strep throat, for example, but it won’t do anything for your influenza or common cold.
Here’s how to determine when to take antibiotics, when to take antivirals, and what happens when you take antibiotics you don’t necessarily need (hint: you may be contributing to a global health problem.)
What Kind of Infections Do Antibiotics Treat?
“Antibiotics are only for bacterial infections. A lot of people have a misconception that an antibiotic can fix everything,” says HaVy Ngo-Hamilton, PharmD, pharmacist and clinical consultant at BuzzRx. That’s just not the case, she continues.
Antibiotics kill bacteria. Before taking antibiotics, you need to see a healthcare provider to determine what is causing your symptoms; if it’s not a bacteria, an antibiotic won’t help.
The pain from a bacterial infection is often localized, which means mainly occurring in one spot, explains Roshini Singh, NP, founder of 365 Wellness, a direct primary care medical practice. If you have strep throat, which is caused by a bacterial infection, you’ll likely have severe pain around your throat and you may also have a fever.
If you have achiness throughout your entire body, that’s more likely a viral illness.
While there are some generalized signs, it can often be hard to tell for sure if you have a bacterial or viral infection, says Dr. Ngo-Hamilton. The best way to figure out exactly what you’re dealing with, she continues, is to go to a doctor or an urgent care. These visits will typically involve a simple test or two, such as a nasal or throat swab, the results of which will help your physician determine the best course of treatment.
If you have a bacterial infection and your healthcare provider doesn’t think your immune system is likely to fight it off easily, they’ll prescribe an antibiotic tailored to treat your specific condition. “Different categories of antibiotics treat different types of bacteria,” adds Singh.
Seasonal Infections That Might Require Antibiotic Treatment
- Strep throat
- Certain cases of pneumonia (such as those caused by the bacteria Mycoplasma pneumoniae)
- Certain sinus infections (such as those caused by the bacteria Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes)
- Certain ear infections (such as those caused by Streptococcus pneumoniae and Haemophilus influenzae)
Antibiotic Resistance: What Happens When You Take Antibiotics You Don’t Need?
Sometimes, antibiotics are overprescribed by doctors wanting to please patients who believe that the drugs will help them overcome any type of infection, says Singh. Or some of us might be tempted to dig out leftover antibiotics from a past illness and take them immediately, rather than waiting to see a doctor. This is a mistake, explains Dr. Ngo-Hamilton.
A common side effect of antibiotics is digestive upset. Like the rest of our body, our gut is naturally filled with good bacteria. The healthy bacteria in our stomachs help us digest the food we eat. Unfortunately, antibiotics don’t discriminate—they kill off these healthy bacteria along with the harmful microbes causing the illness. This disruption to our gut’s natural balance can lead to nausea, diarrhea, and other gastrointestinal issues.
The other effect of taking unnecessary antibiotics is less obvious but more concerning, explains Dr. Ngo-Hamilton. Antimicrobial resistance—when bacteria evolve to survive exposure to certain antibiotics—can affect us on both an individual and population level.
The thing is, antibiotics don’t just destroy healthy gut bacteria, they can kill other bacteria throughout your body, leaving only those bacteria with genes that allow them to survive the antibiotic.
If you take antibiotics when you don’t need them, such as when you have a viral infection, there’s a chance that if you get a bacterial infection in the future, those same antibiotics will no longer be able to kill the bacteria in your body, because the bacteria will have evolved to outsmart the medication. If that mutated bacteria spreads to others in your community, they’ll also have antibiotic-resistant infections. In some cases, these bacteria that can’t be destroyed with antibiotics can spread throughout hospitals, causing serious illness and even deaths, expecially in people with weakened immune systems.
For example, the U.S. is currently facing an ongoing epidemic of Clostridioides difficile (C. diff), a bacteria that infects the digestive tract, causing diarrhea and inflammation in the colon. When antibiotics kill the good bacteria in your gut, these bacteria can take over and are often resistant to antibiotics. The infection is especially common within hospitals among vulnerable patients. Of those who experience and clear a C. diff infection, one out of six will be reinfected within eight weeks. In many cases, the infection is deadly.
There are more than 2.8 million infections each year in the U.S. that are resistant to antimicrobial medications (including antibiotics, antivirals and antifungals.)
“When you start feeling sick, or you have kids who start feeling sick, you get worried. You want to do something for them to fix it immediately, I would advise everyone to reach out to their doctor or even use your local pharmacist,” says Dr. Ngo-Hamilton. “Do not take leftover antibiotics. Don’t take antibiotics that are from somebody else, from your friends, from your family.”
What Kind of Infection Do Antivirals Treat?
Antivirals prevent viruses from replicating in your body, helping your immune system clear the infection faster than it could on its own. These drugs include Tamiflu for influenza and Paxlovid for COVID-19. They’re typically most effective if taken as soon as possible after you become sick. “If it’s been more than three days [since symptoms have started], we tend not to give Tamiflu,” says Singh.
Many of the most common seasonal illnesses are caused by viruses, such as:
- Influenza
- COVID-19
- Common colds
- (Non-strep) sore throats
- Most bronchitis
- Some ear infections
- Most sinus infections
- Some pneumonia
- Respiratory Syncytial Virus (RSV)
Natural Virus Remedies (And When to See a Doctor)
In many cases, if your illness is caused by a virus, getting lots of rest, drinking fluids, and taking over-the-counter medications such as Tylenol (acetaminophen) or Advil (ibuprofen) as needed while your immune system fights the infection is your best bet. Antibiotics will not help a viral infection. And while Tamiflu may help in some cases of influenza, there are no medications to clear the common cold.
OTC medications can ease your symptoms while your immune system does its job, but not all OTC medications are created equal (you may want to avoid ones that include the ingredient phenylephrine for congestion), so it’s important to talk to a pharmacist or a healthcare professional if you’re unsure of the quality of specific brands on the shelf.
“It can take one to two weeks,” for the common cold or flu to go away, says Singh. She recommends supplementing with zinc, which may shorten the duration of common colds, according to a review of 31 studies.
If you’re at higher risk of severe outcomes from flu or COVID, you should contact your healthcare provider at the first sign of respiratory symptoms (such as cough or fever.) If you are otherwise healthy, you can rest at home. These are signs you should see a doctor, according to the Centers for Disease Control and Prevention (CDC):
- Trouble breathing or fast breathing
- Dehydration
- Fever that lasts longer than four days
- Symptoms that last more than 10 days without getting better
- Symptoms, such as fever or cough, that improve then return or worsen
The bottom line: When you’re feeling sick enough to consider medication but aren’t sure what kind of infection you’re dealing with, check in with a doctor to get a diagnosis. That diagnosis will steer you toward the right treatment—and hopefully help to keep antimicrobial resistance in check.
