Avoid antibiotics for minor illnesses, doctors told

Publication Date:24/07/2008

GPs have been advised not to prescribe antibiotics for minor conditions such as coughs, colds and ear infections. Antibiotics don't usually help with these illnesses, and may cause side effects. The overuse of antibiotics has also helped create superbugs.

What do we know already?

Most people get a cough, cold, sore throat or similar illness at least once a year. These illnesses are among the most common reasons for seeing a doctor. Many people, including some doctors, believe that these infections need treatment with antibiotics. Yet we're constantly told antibiotics are used too much. Why?

One reason is that antibiotics simply don't work for many illnesses. Antibiotics don't kill viruses, which are the major cause of coughs and colds. So there’s no point in taking them for these illnesses.

Another problem is the rise of superbugs. The more widely antibiotics are used, the more bacteria can become resistant to their effects. Superbugs are bacteria that have become immune to most antibiotics. This makes infections caused by superbugs very hard to treat.

Taking antibiotics when you don't need them can also mean you run an unnecessary risk of side effects. Antibiotics are generally a safe treatment, but common problems include feeling sick, getting diarrhoea or having a rash. Very rarely, people get severe allergic reactions to an antibiotic they're taking.

What does the new guidance say?

The advice suggests that doctors think twice before prescribing antibiotics to treat coughs, colds, sinusitis, ear infections, sore throats or tonsillitis. Your doctor may suggest you avoid antibiotics altogether, or write a prescription and ask you to wait a few days before you use it. If you feel better, you won't need treatment. If you don't improve, or you start to feel worse, you can use the prescription without needing to see your doctor again.

Antibiotics can still be prescribed when doctors think they're needed. For example, antibiotics are still recommended for anyone with severe tonsillitis, for very young children or for the elderly.

The new guideline applies to GPs, walk-in centres, and accident and emergency departments.

Where does the guidance come from?

The guideline comes from the National Institute for Health and Clinical Excellence, better known as NICE. NICE is the organisation that advises how treatments should be used in the NHS.

What does this mean for me?

If you have an illness that's likely to go away on its own, your doctor might suggest that you don't bother with antibiotics. Or you might be given a prescription to use in a few days if you haven't started to feel better.

There's an old joke that says colds last a week with treatment, and seven days without. It's annoying just waiting to get better, but it might help if you know how long you can expect to suffer. Here's the average recovery time for some common illnesses.

Ear infections usually get better after about four days
Sore throats last about a week
Colds usually last a week and a half
Sinusitis tends to last two and a half weeks
Coughs go away after about three weeks.

Doctors are still free to prescribe antibiotics whenever they think they're needed. So, if you have an illness that will benefit from antibiotics, the new guideline shouldn't affect your care.

What should I do now?

If you have a cough or a cold, there are things you can do to help yourself feel better while your body fights off a virus. Painkillers like paracetamol and ibuprofen can help with headaches, muscle pains and a temperature. Your doctor or pharmacist can advise you about what to take. You could also try home remedies, such as honey and lemon for a sore throat, or breathing water vapour to relieve a blocked nose.

Check the instructions when you're taking over-the-counter medicines. Remember that many cold remedies contain paracetamol, which can be dangerous if you take too much. Be especially careful if you're taking more than one product.

Whatever your illness, see your doctor if you start to feel worse or if you don't start to improve in a reasonable time.

From: National Institute for Health and Clinical Excellence. Respiratory tract infections: antibiotic prescribing. Available at www.nice.org.uk/CG69

To read more, see our information on the common cold, bronchitis, sore throats, tonsillitis and ear infections.

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This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.