Should you really take antibiotics to cure a cold? Experts have their say

Pharmacists are regularly facing pressure from patients to prescribe antibiotics for common colds, a new survey reveals.

The National Pharmacy Association (NPA) polled around 400 pharmacists, finding that nearly 80% refuse requests for antibiotics for minor ailments like colds at least daily. This highlights the persistent misconception that antibiotics are effective against viral infections like the common cold, despite the fact they only combat bacterial infections.

The survey also uncovered concerning trends regarding antibiotic misuse. A quarter of pharmacists reported patients frequently returning partially used courses of antibiotics, a practice that can contribute to antibiotic resistance. Furthermore, over a third of those surveyed were aware of patients stockpiling antibiotics for future use, another practice that fuels the growing problem of antibiotic resistance. These findings underscore the need for continued public education on the appropriate use of antibiotics and the risks associated with their misuse.

With this in mind, we want to know if you should take antibiotics for a cold – and are there any potential consequences of doing this?

“The common cold is a viral infection that primarily affects the upper respiratory tract and it’s caused by various viruses, with rhinoviruses being the most common,” says Dr Naveed Asif, GP at The London General Practice. “Colds are highly contagious and can spread through respiratory droplets when an infected person coughs or sneezes, or by touching contaminated surfaces and then touching the face.”

Do antibiotics work against viruses like the cold? 

“Antibiotics are designed to combat bacterial infections, not viral ones like the common cold,” explains Asif. “Since colds are caused by viruses, antibiotics do not help.

“Using antibiotics for viral infections not only fails to provide relief but can also contribute to side effects, most commonly stomach upset, and antibiotic resistance, making it harder to fight bacterial infections in the future.”

“It’s a really common misconception,” recognises Dr Chun Tang, GP at Pall Mall Medical. “People often associate antibiotics with ‘strong’ medicine and assume they’ll help them feel better faster.

“Sometimes there’s pressure to get back to work or school quickly. And because the symptoms can feel quite awful like a sore throat, congestion, and a cough, people just want relief.”

What are the symptoms of a cold that people often confuse with bacterial infections?

“Cold symptoms like a sore throat, runny nose, and cough can overlap with bacterial infections like tonsillitis or sinusitis,” notes Tang. “Even green or yellow mucus doesn’t necessarily mean it’s bacterial, it’s usually just part of the normal immune response.”

The duration and severity of symptoms can help differentiate between a viral or a bacterial infection.

“A cold usually gets better within seven to 10 days,” highlights Tang. “If symptoms last longer or suddenly get worse after starting to improve, that might be a sign of a bacterial infection and it’s probably a good idea to book a GP appointment.”

What are the potential risks of taking antibiotics unnecessarily?

Some 77% of the pharmacists surveyed in The NPA poll said that they felt demand for antibiotics could pose a risk to patient safety owing to the rise of antimicrobial resistance (AMR).

“The most significant concern is the development of antibiotic resistance, which occurs when bacteria evolve to withstand the effects of these medications,” says Asif. “This can result in more severe infections that are harder to treat.

“Other potential side effects include gastrointestinal disturbances, allergic reactions, and disruption of the body’s natural microbiome.”

To recover from a cold, Asif recommends on focusing on supportive care.

“Staying hydrated, getting plenty of rest, and using over-the-counter medications to relieve symptoms can be effective,” says Asif. “Warm fluids, such as teas and soups, can soothe a sore throat and help alleviate congestion.

“Humidifiers and saline nasal sprays may also provide comfort.”

When is it appropriate to use antibiotics for respiratory symptoms?

“Antibiotics are only appropriate when there’s clear evidence of a bacterial infection like pneumonia, strep throat, or a sinus infection that’s not clearing,” clarifies Tang. “We usually look at the duration, severity, and pattern of symptoms.

“If someone has a high temperature, difficulty breathing, or worsening symptoms after initially improving, we might consider it. But in most mild respiratory illnesses, antibiotics just aren’t needed.”