The first thought many people have when they get a sore throat, fever, cough and congestion is that they need antibiotics, but that’s not always the case. Mohita Patel, M.D., a board-certified family care physician with USMD Frisco in Frisco, Texas says antibiotics aren’t always appropriate.

While primary care physicians often feel pressured by patients to prescribe antibiotics, a recent study in the Journal of the American Medical Association revealed 30 percent of all oral antibiotics prescribed in the United States are unnecessary. The study also noted that these prescriptions are higher for young children and for people living in the South.

“Antibiotics are only effective when treating bacterial infections, not viruses,” Dr. Patel says. “Most colds, sore throats, coughing and bronchitis tend to be caused by viruses rather than bacteria.”
And just like bacterial infections, viral infections can cause fever, chills and fatigue. How do you know if your illness is caused by bacteria or a virus?

In cases such as a severe sore throat, the doctor can swab the back of their patient’s throat to test for a bacterial infection such as strep. If the test is positive, the patient will be prescribed antibiotics.

Coughs and fevers are harder to pin down. “If there’s any point where symptoms aren’t getting better after 7 to 10 days—or they were getting better, but then became worse—that can indicate a bacterial infection,” says Dr. Patel.

Doctors are right to be more conservative about prescribing antibiotics. Decades ago during the “golden age of antibiotics,” pharmaceutical companies developed an arsenal of highly effective bacteria killers. That’s not the case anymore. According to the Pew Charitable Trust, the last time science discovered a truly new antibiotic that made it to market was 1984.

“We’re using the same antibiotics we’ve used for decades,” Dr. Patel says. “Overuse of the antibiotics that we do have can lead to antibiotic resistance—which can be dangerous for patients, especially children.”

Along with the danger of resistance, antibiotics can cause side effects such as diarrhea and nausea, or more serious reactions.

“Many people are allergic to antibiotics,” says Dr. Patel. “You may take an antibiotic once and be fine, but the second or third time you use it, you could experience a negative reaction. You can develop an allergy, and it can even be a pretty severe allergic reaction.”

So if you arrive at an appointment determined to get a prescription for antibiotics, don’t be surprised if your doctor recommends a different course of treatment.  “If you have a virus and you’re treated with an antibiotic, you’re not going to feel better,” Dr. Patel says. “Most antibiotic regimens are five to 10 days. With a virus, you’re going to feel better within that same time frame, so while you may think you feel better because of the antibiotic, you would have felt better anyway.”