The key word here is virus, and the key statement is ‘antibiotics do not cure viruses’.
It is that time of year, winter, when colds and flus (viruses) are spread much easier due to the nature of winter bringing everyone into closer contact.
It is often a tough discussion, convincing patients on the benefit, or lack there of, for taking an antibiotic with the cold/flu. Often a ‘cold’ has a hit for 4-7 days, and the more severe ones being 7-10 days, with flus considered to be 10-14 days. A point to also consider, that more time following these will also be required to expect return to full health and energy etc.
Antibiotic use in NZ and the developed world is far too high, and is leading to antibiotic resistant strains of bacteria which are becoming more and more of a concern.
What should I be doing during a cold?
Paracetamol, Ibuprofen, Rest, Hydration ( i.e specifically water >1.5L/day, most NZ’ers do not drink enough when they are well let alone when sick) Vit C, Aspirin/betadine/salt water gargles etc.
Cover your cough!! And not just a half attempt, but a full cover, this is how it is spread in general.
Below is a ‘Gem’ from the NZ’s GoodFellow Unit, providing up to date medical advice to GP’s all over NZ which is well worth a read:
Antibiotics not effective for cough and coloured sputum
In this clinical trial, 416 adults presenting with less than one week of cough, discoloured sputum, and at least one other symptom of lower respiratory tract infection (dyspnoea, wheezing, chest discomfort, or chest pain) were randomised to amoxicillin clavulanate 500 mg/125 mg, ibuprofen 600 mg TDS or placebo for 10 days.1
Patients with asthma, COPD, CHF, immunosuppression, severe symptoms or contraindications to NSAIDs were excluded.
At 10 days there was no difference in the resolution of cough between the three groups. This suggests that the coloured sputum in respiratory tract infections is either not representative of infection or if it is then antibiotics make no difference.
Either way, antibiotics do not change the outcome in respiratory tract infection with cough and coloured sputum (sometimes called acute bronchitis).
This is consistent with the findings of another large study using amoxicillin versus placebo.2 Both studies have a low risk of bias.
- Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial. BMJ 2013.
- Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial. Lancet Infectious Diseases 2013
Dr Sam Mayhew
HealthZone Medical GP Doctor
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