Antibiotics and the common cold

You know the symptoms. It often starts with a sore throat, then graduates to the runny nose, cough, nasal congestion. Those symptoms are evidence your immune system is at work fighting off the invading “microbe” so it doesn’t get deep into your respiratory system.
This is a big deal because the common cold is the source of more than 25 million visits to family doctors in a year and a loss of millions of days of work or school in the US. In the face of lost productive time, many people want to beat a cold by using antibiotics thinking it will knock it out.
Antibiotics are one of the great discoveries in modern medical science and along with vaccines are among the top reasons why life expectancy has so vastly increased in the modern era (after clean water and better sanitation). From humble beginnings with the discovery in 1928 by Sir Alexander Fleming of a moldy laboratory contaminant named Penicillium notatum, which later became the medicine penicillin, antibiotics have been discovered and refined only in recent decades.
The concept behind an antibiotic is to create an environment antithetical (anti-) to the growth a bacterium (-biotic), those pesky near-invisible microbes discovered in the late 17th century by Anton van Leeuwenhoek and proved to be the air-borne cause of disease 200 years later by Louis Pasteur. By developing and manufacturing chemicals, many patterned on the discoveries seen in nature, scientists have found many ways to defeat the life-cycle of bacteria and so cure a bacterial illness.
This is great news if you are infected by a bacterium.
However, the vast number of colds (upper respiratory infections or URIs) is caused by viruses. Viruses are very different creatures than bacteria. They are much, much smaller—just some DNA covered by protein—and they must grow inside another organism—even bacteria—even you. But viruses do NOT respond to antibiotics which are designed for bacteria.
So if you go to the doctor expecting an antibiotic for a cold, you may get different advice.–because an antibiotic is the wrong tool. Just like using a screwdriver to pound in a nail—you won’t get far and you’ll ruin something. What you ruin with inappropriate use of antibiotics is the effectiveness of the antibiotic. Being adaptable, bacteria will rapidly change their structure to become resistant to the antibiotic, which it considers an invader!
Instead you may instead get this advice:

  • Wash your hands
  • Sneeze in your elbow or into a tissue that you throw away (and then wash your hands)
  • Eat regular, healthy meals (after washing your hands)
  • Get enough sleep and exercise.

It may be boring advice. But it works. The medicines we use help control our symptoms so we are less uncomfortable, while we are really letting our immune system do the heavy lifting. The immune system is pretty efficient at beating off these viruses. It takes about a week or so to defeat the invader, though you may have a residual cough for a week or two as the body cleans up after the secretions and defenses it made.
An old joke states if you treat a cold it lasts 7 days, if you don’t, it lasts a week. But the best plan is to take steps to avoid getting a cold in the first place (see the above advice).

Be well!

Dr Hoffman

Dr. Rebecca Hoffman is a Family Practitioner and works at Kaiser Permanente in Salmon Creek, which is in Vancouver, Washington. Interests include using diet and healthy living to stay healthy and attending to mental health and its physical manifestations. Personal interests include hiking, jogging, music (she plays the harp), dance, theater, storytelling and writing. She lives with her husband and two daughters.

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