I’m sick but my Doctor will not give me antibiotics, why?

The fall allergy season is in full swing and cold and flu season are just ahead.  This is the time of year when people tend to get sick with upper respiratory symptoms.  Sometimes it is hard to tell if your runny nose and sore throat are from allergies or an infection.  Many people do end up going to the Doctor and are often surprised or even upset when antibiotics are not prescribed.

This is a very common issue and easily misunderstood.  First, allergies cause upper respiratory symptoms like itchy watery eyes, runny nose, cough and sneezing.  This was once called Hay Fever, which is a bad term because allergies do not cause fever.  What if you have a fever, does that mean you need antibiotics?  In most cases the answer is no.  Antibiotics are great medicines used to treat bacterial infections.  They have no role in treating viruses which cause most upper respiratory tract infections.  Unnecessary antibiotics are not helpful and can be harmful.  Antibiotics can cause gastrointestinal symptoms, rash and even life threatening conditions.   Also, giving antibiotics can lead to resistant bacterial strains like Methicillin resistant Staph auerus (MRSA).  Withholding antibiotics when they are not needed is an important step in preventing potential side effects.   This is why many doctors will check for a bacterial illness before prescribing antibiotics, like swabbing the tonsils to check for strep throat.  Most viral illness will run their course over a few days but the symptoms can be controlled with over the counter and prescription medicines.  Most healthy people will get better without any treatment but be sure to tell your Doctor what symptoms are bothering you so that they can help treat those symptoms.

How can I tell if I have a bacterial infection?  Bacterial infections can set in as the result of a viral infection.  If you have symptoms that start to get better but get worse again, this may be from a bacterial infection.  This is something known as “double worsening” and is often associated with bacterial infections.  It is important to tell your doctor if you have a problem with your immune system, diabetes or valvular heart disease because antibiotics may be given to prevent a potential bacterial infection.   The goal of treating any illness is to first do no harm.  Your Doctor can help you by treating your symptoms and identifying the cause of your illness.  If you have allergies or the common cold, symptomatic treatment is all that is needed.   If your Doctor suspects a bacterial infection antibiotics are indicated.  Keep in mind that it may take several days for your symptoms to improve, so be sure to use the full course of antibiotics.  Also be sure to report any side effects like hives or rash as these usually indicate an allergy to the medicine.  Remember that you can always ask your Doctor to explain why they feel antibiotics are not indicated.