Medical Moment: Antibiotics For A Cold?

Medical Moment: Antibiotics For A Cold?

Telluride Inside… and Out is proud to feature the Telluride Medical Center’s MEDICAL MOMENT, a weekly column that answers common medical questions in pop culture. Have a question for the doctors? Click here to send.

Nationally certified Physicians Assistant Laura Cattell answers this weeks question: When should you seek medical attention and consider antibiotics for a cold?  

Laura Cattell, PA-C

Laura Cattell, PA-C

During cold and flu season, you may have experienced symptoms that don’t seem to go away. You may have wondered “Is this viral or bacterial, and do I need antibiotics.”

In the case of a cough or acute bronchitis, it is almost always caused by a viral infection and will resolve without antibiotics. Acute bronchitis is a self-limited inflammation of the bronchi due to upper airway infection. Patients with acute bronchitis will present with a cough lasting more than five days and potentially up to three weeks.

Guidelines from the American College of Physicians and the Centers for Disease Control (CDC) state unequivocally that pertussis or Whooping Cough is the only indication for antibacterial agents in the treatment of acute bronchitis. If the cough is causing severe coughing spasms, to the point of vomiting or a “whooping” sound is noted, evaluation by a health care provider is recommended.

What should you do in the case of a sinus infection?  Sinus infections, also known as acute rhinosinusitis, are extremely common. One in seven persons will contract a sinus infection once a year; with a cost of over 3 billion dollars to the health care system and even higher indirect costs due to missed work and low productivity.

However, bacterial sinusitis occurs in less than 2% of all adult cases. This percentage is only slightly higher in children.  The most common cause of an acute sinus infection is viral and typically begins as a common cold. Even in persons with a mild bacterial sinus infection, 75% will improve without antibiotics.

What are typical sinus infection symptoms?:

• Nasal congestion or blockage
• Thick yellow to green nasal discharge (green does not mean bacterial)
• Face or tooth pain, especially if on one side
• Tenderness over the sinuses (on either side of your nose or forehead) which may be worse when bending over

What can I do to help the symptoms?:

• Use pain relief medications such as Tylenol or Ibuprofen
• Nasal irrigation by flushing the nose with saline solutions
• Use nasal decongestants as directed.  (Note:  Oral decongestants may provide relief but should not be taken if you have a history of high blood pressure or other cardiac concerns.)
• Steroid Nasal sprays can help reduce swelling

If you think that you may have pneumonia, you should contact your physician.  Common symptoms of pneumonia include:

• Fever greater than 100.5 F with chills
• Shortness of breath, pain with breathing
• Rapid heart and breathing rate
• Nausea, vomiting, diarrhea
• Cough that often produces green, yellow and occasionally rust colored sputum

So when should you see a doctor and consider antibiotics?  Guidelines published by the Infectious Diseases Society of America recommend the following criteria to distinguish viral from bacterial:

• Persistent symptoms lasting 10 or more days without improvement
• Onset of severe symptoms; including fever of 102 F, purulent nasal discharge or facial pain for at least 3 days
• Onset of worsening symptoms following a cold which appeared to improving

If you have any concerns regarding your symptoms, it is recommended that you schedule an appointment.

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