If you’re coughing and sneezing for more than a week, don’t assume that antibiotics are the answer

Antibiotics

Do you know when to take antibiotics? © iStock

There are more than 42 million prescriptions written for antibiotics each year. But many of these aren’t actually doing us any good. All colds and most coughs and sore throats are caused by viruses, so taking antibiotics has no effect whatsoever.

Despite this, 97% of patients who ask for them leave with a prescription because nine out of 10 GPs feel pressurised to give them, according to The National Institute for Health and Care Excellence (NICE), which advises the NHS on care and treatments.

In an attempt to curb the problem, NICE has issued new guidelines which it hopes will cut the number of prescriptions given each year by around a quarter. But patients need to change their assumptions and expectations for the new rules to work.

GP and antibiotics expert Dr Rob Hicks says that apart from wasting millions of pounds, there are two major problems with prescribing antibiotics that aren’t necessary. He says: ‘The first is the increasing global problem of antibiotic-resistant bacteria making it harder to treat some infections.

Secondly, if medicines are given to individuals who don’t need them, the risk of side effects is far greater than any potential benefits.’

So, here’s a guide to when you can do without antibiotics – and when you can’t. But if you’re concerned about your health, always speak to your GP, or a pharmacist.

Dr Hicks says: ‘They have a vast knowledge of over-the-counter remedies and will redirect people to their GP if necessary.’

For more information, see treatyourselfbetter.co.uk.

Who knew?

Most people see their GP too quickly because they underestimate how long winter ailments can last.

For instance, research shows that 98% of people expect a cough to last around eight days when, in fact, it can last up to three weeks. And 80% expect flu symptoms to last only 10 days when two weeks is the norm.

Earache

Children are most prone to ear infections because the narrow air passages in their inner ear can easily become blocked by mucus.

Antibiotics are rarely needed for ear infections as the cause is usually viral and, even if the infection is due to bacteria, we now know that they get better on their own.

When to take antibiotics:

If the earache doesn’t start getting better within a few days or the pain gets worse despite taking age-appropriate paracetamol or ibuprofen, or there’s a discharge from the ear, then contact your GP.

Chesty cough

It’s normal for a cough to last up to three weeks. And, although it was thought that a cough producing green phlegm indicated a bacterial infection, antibiotics are no longer prescribed according to the colour of sputum.

Treatment is rest and fluids. The jury is still out on the benefits of over-the-counter cough medicines. There’s no science to back claims they help and coughing is the body’s way of clearing the lungs of any infection.

But, if a cough medicine provides short-term relief, there’s no harm in taking it.

When to take antibiotics:

If your cough is accompanied by a persistent fever, difficulty breathing, pain in the chest or blood-stained phlegm, see your GP. Also, visit your GP if you have a chest infection, which affects the lungs.

This is different from a normal cough and is more common in young children and the elderly; smokers; those with a weakened immune system or a pre-existing respiratory condition such as asthma or Chronic Obstructive Pulmonary Disease (COPD).

Sore throat

The majority of sore throats are caused by viral infections. But even if caused by a bacterial infection, research shows that antibiotics have very little impact on symptoms or recovery time.

It’s far more effective to rest, drink plenty of fluids and try home remedies, such as honey, lemon and ginger in a hot drink. Sucking over-the-counter throat lozenges can also soothe soreness.

When to take antibiotics:

Vulnerable patients, such as those with a weakened immune system because they have cancer, for instance, may require antibiotics.

And if symptoms don’t improve or get worse or you have associated symptoms, such as drooling and difficulty swallowing which could indicate a nasty bout of bacterial tonsillitis, see your GP.

Skin conditions

Most skin complaints – eczema, psoriasis, ringworm, etc – will see no improvement with antibiotics.

When to take antibiotics:

Antibiotics are prescribed for infected eczema (a flare-up resulting in skin that’s redder and more weepy than normal) and cellulitis (an infection of the deeper layers of the skin).

They may also be prescribed as a long-term treatment for acne, but this is because of their anti-inflammatory effect – not for bacterial infection.

Eye complaints

GPs no longer routinely prescribe eye drops and ointments for eye infections, such as conjunctivitis. Even if the cause is a bacterial infection, rather than a virus, it usually clears up
on its own.

When to take antibiotics:

If the symptoms are very severe despite sterile bathing (using cotton-wool balls to clean the eyes with cooled boiled water) or last longer than two weeks, see your GP.

Urine infections

These are more common in women because their shorter urethra makes it easier for bacteria to invade the urinary tract.

A UTI (or cystitis) in women can often clear up with over-the-counter treatments and by drinking more fluids. But children and men with symptoms of a urine infection should always seek medical advice.

Women experiencing symptoms for the first time or that last more than five days, or feel a lot of discomfort, or those who have recurrent bouts (more than three times a year) should see their GP.

When to take antibiotics:

If symptoms get worse despite self-treatment measures, or the patient develops a fever and abdominal or loin pain, this may indicate a kidney infection (pyelonephritis) which would definitely require antibiotics.

Sinusitis

Sinusitis is inflammation of the sinuses, usually due to a viral infection, so antibiotics won’t help.

It can last up to two and a half weeks, so rest up, drink fluids and take simple painkillers. Steam inhalations – bending over a bowl of steaming hot water with a towel over your head – can relieve congestion in the sinuses, while decongestants can also relieve the bunged-up feeling.

When to take antibiotics:

If symptoms get worse, stagnation of fluid in the sinuses may have allowed a bacterial infection to develop so antibiotics might be needed.

And remember…

If you are prescribed antibiotics, always complete the course – even if you feel better after a few days. Failing to do so contributes to the growing problem of resistant bacteria.