Do You Need Antibiotics for that …?

“How do you know if you need antibiotics anyway?” my husband literally asked me while I was preparing a post recently. Yes, this is my own husband. The husband of a Family Physician, queen of virus vs bacteria by day, and the man I have been with for over 8 years now. I was offended.

It did make the Family Physician in me realize, though, that the answer to that question is not as easy as you would think. No wonder patients think that a Z-pack or Amoxicillin will cure everything. My own husband is one of those people (and he hears me talk about this A LOT).

You see, there are different kinds of infection. The two largest classes being viral and bacterial infections. They both plaque humanity but in different ways and with different remedies. Antibiotics treat only bacterial infections. NOT viral infections.

Antibiotics Treat ONLY Bacterial Infections

With a few exceptions (there always have to be exceptions to make this difficult, right?), viruses have NO treatment. We just support the symptoms with medications like Tylenol and Aleve for fevers, pains, etc., to make you less miserable while the virus runs its course. For the over-achievers out there, the common viruses that do have treatment options are Influenza, Herpes/Shingles, and HIV.

So, how do you know if your infection is most likely VIRAL in nature?

Viral infectious symptoms typically affect MULTIPLE places and tend to be LESS severe than bacterial infections in those areas. Remember, there is no treatment for most viral infections.

Let’s simplify this by looking at a few common VIRAL infections:

Common Cold (Rhinovirus): sore throat, runny nose, ear pain, cough, low grade fever – multiple locations and less severe

Stomach Bug (Viral Gastroenteritis): nausea, vomiting, diarrhea, low-grade fever – less severe

Viral rash (Viral Exanthem): rash all over the body that appears after or during illness, little to no symptoms – multiple locations and not as severe

How Do You Know if Your Infection is BACTERIAL in nature?

Bacterial infection are more likely to affect 1 LOCATION and symptoms in that location are MORE severe. Remember, bacterial infections ARE treated with antibiotics and need to be assessed by your Doctor.

Let’s look at a few common examples of BACTERIAL infections:

Ear infections (Otitis Media): pain typically in 1 ear only, no cough or runny nose, low-grade fever – 1 location and more severe

Strep throat: extreme sore throat, higher fever, NO cough, no runny nose – 1 location and more severe

Cellulitis: skin infection by bacteria in 1 localized area of the body, skin is thick, warm, and painful – 1 locations and more severe

Bacterial gastroenteritis (E.coli, Salmonella, Shigella, Campylobacter): severe cramping, diarrhea, blood in stools, high fevers – more severe

Think of it this way – when was the last time you “caught” an ear infection from your child? How about a cold? Bacteria effect only the ear in ear infections but a cold hits many locations and spreads quickly.

Do you need antibiotics

Why does it matter anyway?

Here’s why it matters: There are a limited number of antibiotics to treat bacterial infections. And there are not many coming down the pike. You want them to work WHEN YOU NEED THEM and not for a simple cold. Antibiotics DO NOT work to treat viral infections.

A perfect historical example is Azithromycin or the “Z-pack”. Doctors used to give that out like water. Then something happened. People started to become resistant to it.

They also started having side-effects from being on antibiotics too long. Clostridium difficile infections, causing profuse watery diarrhea, increased because the antibiotics cleared out the good bacteria in the gut. Yuck. We also started to see “super bugs”. These are bacteria that are very difficult to treat and require IV medications. All BAD things.

As I stated, most viral infections last 7-10 days. When patients came in on day 2-3 of a viral infection and started the Z-pack, their symptoms improved in about 5 days. That was convenient – the Z-pack 5 day treatment aligned with the resolution of their symptoms but likely had little to do with it. People thought the medication was amazing but it actually did little in the process. What did? Time. Because it was a viral infection.

Should You Have Your Doctor Examine You for a Virus?

If you are questioning your symptoms, it is NEVER wrong to have your Doctor check you over. In fact, I would recommend it. Sometimes your symptoms are not that clear cut and you are better to be safe. Just remember, your Doctor not giving you antibiotics is NOT a bad thing. You don’t want them if you don’t need them. Trust me.

Simple Solution: You can recognize a virus by milder wide-spread symptoms. Think of the common cold. Over-the-counter symptomatic support is the answer. A bacterial infection will look more severe and be isolated in nature. Think ear infection or strep throat. You will need antibiotics to treat these infections.

For more on Viral Outbreaks, check out :

On Antibiotic Resistance:

For More Blog Posts on Things that Make You Sick, check out:



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