When do you need antibiotics for a cold?


Colds are ubiquitous, especially in certain times of the year. Every adult in Germany is caught on average two to four times a year, children even more often. To date, there are still no drugs that reliably fight a cold or prevent it in advance.

Many patients still believe they need to take an antibiotic in the hope of getting better as soon as possible. But the effectiveness of antibiotics for colds is controversial. An antibiotic only rarely helps to get rid of the common cold faster. In addition, antibiotics often have unpleasant side effects. In addition, the number of bacteria that are resistant to certain antibiotics continues to increase. Another possible avoidable cause of this trend is the unnecessary prescribing of antibiotics, such as for colds.

For more information, read also:

  • Treating the flu
  • How can I shorten the duration of a cold?

Are Antibiotics Useful?

The term antibiotic simply refers to a substance that kills microorganisms. In general medical parlance, antibiotics are understood to be substances that kill bacteria or restrict their reproduction. However, antibiotics do not work with viruses!

The problem with colds, however, is that an estimated 98% of colds are caused by viruses alone. The most common pathogens are the so-called parainfluenza, rhino, or adenoviruses. From this it can be concluded that in 98% of colds antibiotics simply do not help and can even cause unpleasant side effects. Antibiotics only have a positive effect in very few cases (approx. 2%). (See superinfection)

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When should antibiotics be used?

In certain cases, antibiotics must be used even if you have a cold. The common cold itself is almost always caused by viruses, but in rare cases it can develop into a so-called superinfection, in which in addition to the viral infection there is also a bacterial infection. It is estimated that this affects every fiftieth person with a cold.The bacteria can multiply particularly well because the immune system is already weakened by the existing virus infection. Then it comes to a sinus infection, for example (Sinusitis), bronchitis, otitis media or severe sore throat (Pharyngitis).

Read our article about a Cold caused by bacteria

Whether treatment with antibiotics then has to be carried out should still be decided individually by a doctor. A common reason for prescribing antibiotics is inflammation of the tonsils (Tonsillitis) because of bacterial colonization, which is particularly common in childhood. In addition, antibiotics must be prescribed by a doctor if pneumonia is present (pneumonia).

However, these diseases also usually have clear symptoms that can easily be differentiated from a cold. These include, for example, a fever over 38 ° C, an increased breathing rate with shortness of breath and an increased pulse.

Which antibiotics are used?

Due to the increasing development of resistance and also due to the numerous newly developed antibiotics, a doctor has to weigh more and more carefully which of the numerous preparations to prescribe the patient if he suspects a bacterial infection. When an antibiotic is needed, bacteria have lodged on the lining of the airways. These bacteria have often lived on the mucous membrane before without causing any symptoms. Most of the bacteria resident there have similar properties and can therefore be attacked with typical antibiotics. However, before prescribing the doctor, the doctor must select his antibiotic carefully, as different antibiotics work against different types. Tonsillitis (Tonsillitis) is treated with a different antibiotic than pneumonia (pneumonia).

The most commonly prescribed antibiotics for an upper respiratory tract infection are called beta-lactam antibiotics. The most famous representative of this group is the well-known penicillin. A slightly modified form is the so-called amoxicillin, which is also often prescribed. Since there are often allergies to this type of antibiotics, so-called macrolide antibiotics such as erythromycin are sometimes prescribed. Antibiotics from the group of cephalosporins, to which the active ingredient cefuroxime belongs, are also often prescribed. These are similar in their mechanism of action to penicillin and should not be taken if you suspect or have an allergy to beta-lactam antibiotics (also called penicillin allergy).

What are the side effects?

Antibiotics can cause a number of side effects. Many antibiotics have similar side effects: Probably the most common side effect that can occur with all antibiotics that are taken in tablet form are gastrointestinal complaints. This usually manifests itself in the form of nausea, abdominal pain, gas and / or diarrhea.

Rarer side effects such as fungal infections in the mouth or gastrointestinal tract, headaches, insomnia, dizziness, drop in blood pressure or joint problems and torn tendons. The possible side effects often vary from antibiotic to antibiotic. Please always refer to the package insert for the antibiotic in each individual case.

It is also generally recommended not to exercise while taking antibiotics. With some antibiotics, it is also important to note that you should not drink some foods, milk or alcohol in order to avoid side effects as far as possible.

Also read:

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  • Exercise with a cold

What can I do if antibiotics don't help?

If the antibiotic ingested does not relieve the symptoms, a doctor should always be consulted! Because normally, when treating a bacterial infection, there is a significant improvement in symptoms within the first two days. However, there can be other reasons why antibiotics do not help with a cold: The simplest reason for this would be that there may be a viral infection rather than a bacterial infection and antibiotics are still being taken. So if antibiotics have been prescribed but there is actually no bacterial infection at all, the duration of the cold is not shortened and the symptoms persist. Then the cold itself should continue to be treated.

also read: Common cold home remedies

Am I still contagious if I take antibiotics?

Whether or not you are still contagious after taking an antibiotic depends heavily on which disease is being treated with the antibiotic. If a bacterial infection is also treated as part of a cold, the cold, which was primarily caused by viruses, is still contagious because it cannot be fought with an antibiotic.

In the case of a bacterial tonsillitis (also called tonsillitis or angina), the risk of infection for fellow human beings is usually very low again within 1-2 days after the start of antibiotic therapy. Other diseases, such as pneumonia, can also be contagious for longer, so the attending physician should always be asked how long one should stay at home.

Further information that may be of interest to you: Duration of a cold

In general, however, the typical hygiene measures should always be followed until the symptoms have completely subsided. This includes, for example, avoiding shaking hands with other people in order to reduce the risk of infection for them. In addition, hand hygiene should be observed by washing or disinfecting the hands regularly. Close face-to-face contact should also be avoided, as pathogens can also be transmitted by speaking; this process is called droplet infection.

Please also read: 6-step disinfection - Proper hand washing and disinfection