Be wary of using antibiotics to fight cold and flu
Cold and flu season for many Canadians means getting ready to have their lives and routines thrown off by painful and annoying symptoms. This can mean days off work or school dealing with sore throats, nasal congestion and fever. For parents, it can be challenging to try to comfort young kids with fever, coughing or ear pain.
As doctors, we know that both doctors and patients would love a magic bullet to deal with these symptoms. Unfortunately, antibiotics are not usually the answer.
Antibiotics are commonly misused because people mistakenly believe they will treat the symptoms of colds and flus. In fact, fever, cough and ear pain are usually due a virus — and viruses are not affected by antibiotics.
More than half of all antibiotic prescriptions in Canada are estimated to be unnecessary — and ineffective. Common conditions that are usually viral in nature but that are often prescribed antibiotics unnecessarily include sinus infections, ear infections and chest colds (or bronchitis). Antibiotics do not typically help for any of these conditions and the symptoms will get better with simple rest and time.
What harm can taking unnecessary antibiotics do? Plenty.
When trying to treat symptoms caused by viral infections, antibiotics don’t help and can actually make patients feel worse. When diseases are viral in origin, not bacterial, antibiotics have no impact.
Using an antibiotic when it is not needed also promotes the growth of bacteria that are resistant to commonly-used antibiotics. This makes patients, especially the elderly, more vulnerable to antibiotic-resistant infections and undermines the good that antibiotics can do when they are truly needed.
There are also side effects to taking antibiotics; about one in four people who take antibiotics experience stomach upset, dizziness or skin rashes.
There’s a new tool to help have conversations about when antibiotics aren’t necessary — it’s called a “viral prescription pad.” This is a tear off sheet similar to what you might receive for a prescription, except it contains information about symptom-relieving strategies for fevers, aches and pains. It also explains the risks of unnecessary antibiotics and offers examples of when you should go back to see the doctor.
Receiving no antibiotics for a cold or flu does not mean no treatment. It just means a different approach.
One way to start the conversation with your doctor about whether or not an antibiotic is really necessary is to use these three questions developed by Choosing Wisely Canada when talking with your doctor: Do I really need antibiotics? What are the risks? Are there simpler, safer options? Dr. Guylène Thériault is a family physician and an assistant dean at McGill University. Dr. Wendy Levinson is a professor of medicine at the University of Toronto.