When Antibiotics Are and Aren't Appropriate

One of the most common points of friction in primary care medicine is the request for antibiotics. Patients often come to an appointment expecting — or insisting on — an antibiotic prescription, while their physician knows that the infection is almost certainly viral and antibiotics will not help. Understanding when antibiotics are genuinely indicated, when they aren't, and how to tell the difference, is one of the most practical pieces of medical knowledge a person can have.

What Antibiotics Do And Don'T Do

Antibiotics are drugs that kill or inhibit bacteria. They have absolutely no activity against viruses. This fundamental point cannot be overstated: antibiotics do nothing to treat colds, influenza, COVID-19, most sore throats, most bronchitis episodes, most ear infections in older children, and the vast majority of upper respiratory infections — because these are caused by viruses.

Taking antibiotics for a viral infection does not shorten its duration, reduce its severity, prevent complications (in most cases), or help you recover faster. What it does do is expose you to side effects (diarrhea, yeast infections, allergic reactions), increase your personal risk of carrying resistant bacteria in your microbiome, and contribute to the broader community problem of antibiotic resistance.