If you have the cold or flu, antibiotics are not for you

October is the beginning of three important seasons: professional hockey, basketball — and the flu. Although flu season typically begins right about now, it really cranks up between December and March.

All told, it affects up to 20% of the U.S. population each year. More than 200,000 people are hospitalized­ with it, and more than 36,000 people die from it. It leaves us sniffling, sneezing, coughing, achy and generally feeling miserable for anywhere from a few days to a few weeks. It jeopardizes our ability to work and study, and we’re concerned about passing it on to others, especially family and coworkers.

The need for relief is therefore strong and so we often reach for that favorite catch-all remedy, an antibiotic.

 

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But we now know that’s a bad move, and for two reasons. An antibiotic (read: an anti-bacterial) has no efect whatsoever on a viral-driven illness. And that’s exactly what the flu is, an illness caused by the influenza virus — not by the influenza bacteria (there is no such thing).

In fact, the U.S. Centers for Disease Control reminds us that for the same reason, antibiotics cannot cure the common cold, are almost never needed for bronchitis, are not recommended to treat many ear infections, and are typically not needed to treat a sinus infection (sinusitis).

The second reason we don’t want an antibiotic is they have serious side effects.  A notable one is a Clostridium difficile infection (CDI): profuse diarrhea, abdominal pain and fever, that’s contracted by more than 250,000 people in the U.S. each year, and kills at least 14,000.

CDI normally occurs after antibiotic use. That’s because antibiotics are indiscriminate killers: they kill our beneficial bacteria too — the vast majority of our microorganisms — such as the ones that prevent infection. These infection-preventing bugs work in two ways. They use up nutrients thus making them unavailable to C. diff, or other disease-causing bugs, which are normally present in your gut, but in small numbers. And some of our normal microbiota make compounds that are toxic to C. diff. Thus with beneficial bugs out of the way, C. diff has food to eat, room to grow, and isn’t being knocked-off by toxic chemicals.

So if we don’t reach for an antibiotic to cure the flu, what do we do? The CDC says the best medicine is prevention: i.e., the flu shot. Should we nevertheless come down with the flu, the CDC also reminds us:

Most people with the flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.

If, however, you have symptoms of flu and are in a high risk group, (including young children, people 65 and older, pregnant women and people with certain medical conditions), or are very sick or worried about your illness, contact your health care provider.

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