How can you tell when you need an antibiotic?


Eleanor Collier

When sickness strikes you or your family, how can you tell whether you need an antibiotic or not?

Antibiotics are a medical marvel and have completely transformed modern medicine, but more often than not, they are not the right ‘go to’ solution when you are feeling under the weather.

Colds, coughs, sore throats, flu and tummy bugs are part of family life, so what do you need to know to do the right thing when they strike?

Here’s what to do – and what not to do – when these common illnesses crop up:
Antibiotics for flu – just won’t do

Taking antibiotics for cold and flus just won’t do” is the advice from the HSE, aiming to increase awareness around Ireland of the best way to responsibly use antibiotics and help people with practical advice to make the right choices in managing everyday illnesses.

“Antibiotics are a really precious resource”, stresses the ICGP GP lead on Antibiotics Dr Nuala O’Connor, one of the faces behind “Like the water and our climate, we haven’t dealt with them wisely in the past and we need to use them wisely from now on.”

She stresses that all Irish people now need to play a part in ensuring that antibiotics are not misused and that they’re kept effective for future generations. “Bugs have been around for millions of years.

They are very clever at surviving and as soon as the first antibiotics came in, they were already adapting and resistance started. The problem is that antibiotic resistance is not going to go away.”

People think doctors have “a magic wand”

“Nowadays everyone wants to get better yesterday. They want to get back to work or get their children back to the school or creche as fast as possible. Some people think doctors have a magic wand. We don’t!”

But what difference does the over-use of antibiotics make? “A massive one”, states Dr. O’Connor. “We all need to understand what antibiotics are for – but also what they are not for”.

Global and Irish experts agree that everybody from doctors to patients now have a personal responsibility when it comes to antibiotics.

“It’s a two-way thing”, points out Dr. O’Connor, emphasising that the situation is so serious that deaths from antibiotic resistant infections will actually outstrip deaths from cancer by 2050.

Irish people now use a lot of antibiotics and Ireland already has a relatively high level of antibiotic resistance.

“The situation is grave. It’s estimated that every 10 minutes a patient now dies in Europe from antibiotic resistant infections. By 2050 it is estimated that worldwide there will be the loss of up to 10 million lives per year. We all have to play our part now”.


“A Magic Bullet” – but not for viral infections

“When you have a bacterial infection, antibiotics are ‘magic bullets’. Before the era of antibiotics, it was common for one or two children per household to die from infections. That’s how powerful antibiotics are for us now in this generation”.

“Most of the conditions presented to me in general practice are caused by viruses – runny noses, sore throats, ear aches, chesty coughs, vomiting and diarrhoea and rashes. If a child is sick, you will want to get the temperature down or reduce pain.

For that, you are going to use paracetemol or ibuprofen, give them rest and plenty of fluids. You will not use antibiotics – they are very specific medicines – designed to kill bacteria. They have no effect on viruses – they will not bring down your temperature. They will not relieve pain.”

Can antibiotics harm you or your children?

“If you take antibiotics and you don’t need them it can make bacteria resistant to them. This means that they may not work when you really need them when you have a bacterial illness such as a urinary tract infection, chest infection or meningitis,” says Dr. O’Connor.

“Antibiotics also have harmful effects. Some of these are not serious such as an upset stomach or diarrhoea, but they are avoidable. However many people do not realise antibiotics can have very toxic side-effects.

They can cause life-threatening allergic reactions, liver damage and also can have serious interactions with many commonly used drugs such as cholesterol-lowering medicine.”

“This is another reason why it’s very important that we only use them when they are really needed for bacterial infection. It is important that you make sure whoever is prescribing them for you knows what other regular medication you are taking.”

Whether you have a cold, flu, tummy bug or other minor illness, practical advice and tips are available on developed by the HSE (Ireland’s Health Service Executive) with doctors and pharmacists in Ireland.


Colds and Flu – what should you do?

Colds – can’t be treated with antibiotics

Colds are caused by a virus so they cannot be treated with antibiotics. It’s a myth that antibiotics can help you to get better faster from viral infections such as colds and flu.

Antibiotics have absolutely no effect on viruses, which cause colds and flu as they are designed to kill bacteria. Instead, drink plenty of liquids to replace those lost from sweating and runny noses. Get lots of rest and eat healthily.

Coughs – no quick way out

Most coughs are caused by colds or flu and usually come with other symptoms such as a runny nose, fever, sore throat, earache or general aches and pains.

If your cough is a result of a cold or flu, you do not need to see the doctor. There is no quick way of getting rid of a cough. It will usually clear up after your immune system has defeated the bug that is causing it.

The simplest and cheapest way to ease a tickly or chesty cough is with any of the common over-the-counter remedies. Ask your pharmacist for advice. If it lasts more than 3 weeks go to your doctor.

Earache – help from over-the-counter

Earache usually comes on all of a sudden and the pain can be quite sharp. You may also have a high temperature. The severe pain doesn’t normally last more than a day or two.

Usually, you do not need to see the doctor unless you have a discharge from your ear. Ask your pharmacist about over-the-counter medicines to help with the pain and any high temperature.


Flu – choose bed not an antibiotic

Flu or influenza is a severe virus that comes on suddenly and makes you feel very unwell. You need your bed, not an antibiotic. Symptoms like sore throat, fever and muscle ache develop quickly.

Usually, you do not need to see the doctor as most flu’s can be treated at home. Drink plenty of liquids to replace those lost from sweating. Get lots of rest and eat healthily.

If you are at risk of the complications of flu you should see a doctor as you may need special anti-viral medicines. These work best if started within 48 hours of flu symptoms.

How to sooth a sore throat

Sore throats are common and not usually serious. Children and teenagers are more likely to get sore throats than adults and most will clear up within a week. Over-the-counter painkillers can usually relieve the symptoms of a sore throat.

Try to avoid hot food or drink as this could irritate your throat. Eat cool, soft food and drink cool or warm (not hot) liquids. Adults and older children can suck lozenges, hard sweets, ice cubes or ice lollies. Go to a doctor if it persists after two weeks.

Tummy bug? Antibiotics won’t help

Vomiting and diarrhoea can happen on their own or together. When they happen together, it is called gastro-enteritis. This is caused by a tummy bug, usually from contaminated food or people. Vomiting usually lasts between 6 and 12 hours and diarrhoea between 24 and 48 hours.

Usually, there is no specific cure and you need to let the illness run its course. Drink plenty of liquids to make sure you don’t become dehydrated. You don’t need to take anti-diarrhoea medicine unless absolutely necessary and children should not take it.



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