Now that we are in the thick of winter, many of us have been getting sick with respiratory illnesses. A typical first reaction in this situation is “I’d better see my doctor right away for an antibiotic before this gets worse”. But in the vast majority of cases these infections are caused by viruses, and antibiotics (which only treat illnesses caused by bacteria) are unhelpful.

Take the common cold. Symptoms of a cold are sneezing, runny nose, sore throat, and nasal congestion. Colds are ALWAYS caused by viruses, and therefore, antibiotics will NEVER cure a cold. The goal of treatment is to manage your symptoms with medications and other therapeutic measures until the symptoms resolve, usually anywhere from 3-14 days for complete symptom resolution. Options for management of cold symptoms include over-the-counter decongestants such as pseudoephedrine, antihistamines such as diphenhydramine for runny nose and sneezing, and acetaminophen or ibuprofen for sore throat. Drinking plenty of fluids and getting adequate rest will also help you to feel better while you are sick, although these things will not shorten your illness.

Another common infection people develop this time of year is acute sinusitis, or inflammation of the nasal passages and sinuses. Symptoms can include nasal congestion, pain in the teeth or face, thick yellow or green nasal discharge, ear pressure or fullness, and occasionally, fever. The vast majority of sinus infections–more than 98%!–are also caused by viruses, so again, antibiotics will not help or shorten the duration of your symptoms. It can take 7-10 days before a typical sinus infection starts to resolve. Symptoms that suggest a bacterial sinus infection are fever over 102 degrees, sudden worsening of symptoms in the middle of your illness, or an illness that lasts 7-10 days without any improvement–in these cases, it is prudent to schedule an office appointment for an evaluation without delay. You may also schedule an appointment if over-the-counter medications are not controlling your symptoms adequately. Typically, however, the mainstay of management of acute sinusitis is to treat symptoms with nasal decongestants/sprays, nasal saline irrigation, and acetaminophen or ibuprofen for pain (limit the use of nasal sprays such as Afrin to 3 days, as longer use can actually worsen congestion).

The last type of infection we commonly see this time of year is Bronchitis, or inflammation of the large airways in the lungs. Bronchitis presents as coughing and congestion in the chest (commonly described as a “chest cold”), along with mucus which can be yellow or green in color. Again, most of these illnesses are caused by viruses, frequently in conjunction with common cold symptoms, and it can take up to 2-3 weeks before the cough completely resolves (although you should be improving over this time period). Over-the-counter cough medications may offer modest relief of cough symptoms; using a humidifier may also soothe cough and sore throat. Some studies suggest that a teaspoon of honey may be beneficial in soothing cough, as well. Symptoms that may signal a more serious lung infection–such as the flu or pneumonia, or the bacterial infection Bordetella pertussis (“whooping cough”)–include high fevers, fatigue and body aches, coughing up blood, shortness of breath, chest pains, or a barking cough. If you have any of these symptoms, antibiotics or other prescription medications may be indicated, and you should call the office right away to schedule an appointment.

The take-home point is that most of the respiratory infections you may develop this time of year are caused by viruses, and can be safely and effectively treated at home with over-the-counter medications, rest, and TIME. If you do develop a respiratory illness and you are not sure how serious your symptoms are, if any of the “flag” symptoms noted above are present, or if you have a chronic respiratory or other condition that may complicate your illness or treatment, you should always contact us to discuss how you’re feeling or schedule an appointment for an evaluation in the office.