Treating URI

Dad has a cold.  I want him to get an antibiotic but he says he doesn’t need one.  What’s best for treating colds and the flu.


This winter we’ve seen a lot more ‘flu’ [influenza], as well as lots of colds.  People often are prescribed an antibiotic and a shot of steroids but is this really good for them or the community?

A ‘cold’, or Upper Respiratory Infection [URI], or “rhino-sinusitis”, is caused by a virus 98% of the time, and can last 10 days.  Symptoms include slight fever, aching all over, sinus congestion, runny nose/eyes, sore throat, cough.

The ‘flu’, or Influenza, is just a different virus, but one with rapidly worsening symptoms (especially the fever and muscle soreness); it can be fatal in elderly and infants.

Treatment for both is aimed at controlling symptoms.  Acetaminophen or anti-inflammatories [for the aching and fever], nasal salt-water irrigations, plus decongestant or steroid sprays, and Vicks Rub are helpful.  But Zinc does not help, nor do codeine cough syrups, or antihistamine-decongestant ‘cocktails’ (which in seniors only increase the risk of falling and confusion).

However, for influenza, the drug oseltamivir [Tamiflu] can reduce the severity and duration (but only by 1-2 days); family members may take it to reduce their risk of being infected by the sick one.

Are antibiotics ever indicated?  Since 70% of people get better in a week regardless what they do, the national guidelines recommend antibiotics only if:  1) you have a chronic immune-deficiency condition (such as a leukemia); or 2) your symptoms are worsening after 10 days (with a fever over 101 and increasing pain), which suggests you now have a bacterial infection.  Everyone hopes antibiotics work, but evidence shows they’re no better than a placebo for this.  More importantly, their overuse is causing bacterial resistance in the community—meaning the antibiotic won’t work when you really need it.

So, your dad is right.  Use ‘grandma’s remedies’:  take Tylenol, rub his chest/neck with Vicks; and prevent spreading it by washing your hands, covering your mouth/nose when coughing/sneezing and… don’t ask for an antibiotic or ‘shot’.