New Delhi: A prescription for antibiotics can often feel reassuring when a person is suffering from fever, sore throat, cough or a lingering cold. However, medical experts stress that symptoms resembling an infection do not automatically mean that a bacterial infection is present.
Antibiotics are designed to treat bacterial infections and do not work against viruses, which are responsible for most uncomplicated colds, influenza and many cases of acute bronchitis. Using antibiotics when they are not needed may not speed up recovery and can instead cause side effects while contributing to the growing global challenge of antimicrobial resistance.
The issue has gained greater attention as resistance to commonly used antibiotics continues to rise. According to the latest World Health Organization data, one in six laboratory-confirmed bacterial infections causing common infections worldwide showed resistance to antibiotic treatment in 2023.
Antibiotics do not treat viral infections
People sometimes seek antibiotics when symptoms persist for several days, assuming that a prolonged cold or cough must have developed into a bacterial infection. However, the duration of symptoms alone does not establish the need for antibiotics.
Antibiotics specifically target bacteria and have no effect on viruses. Most common colds and cases of influenza are caused by viral infections, which usually improve with rest, hydration and appropriate symptomatic care.
Using antibiotics as a precaution when there is no evidence of a bacterial infection can expose patients to medicines without providing a corresponding benefit. Medical experts emphasise that treatment should be based on an accurate diagnosis rather than the assumption that all infection-like symptoms require antibiotics.
Unnecessary use fuels antibiotic resistance
Antimicrobial resistance is not limited to hospitals or patients with serious illnesses. Every unnecessary course of antibiotics can contribute to the problem by creating selective pressure on bacteria.
When antibiotics are used, susceptible bacteria may be killed while resistant bacteria survive and multiply. Over time, this process can make infections increasingly difficult to treat with medicines that were once effective.
The WHO data showing resistance in one out of every six laboratory-confirmed bacterial infections involving common infections underlines the scale of the challenge. Preserving the effectiveness of existing antibiotics has therefore become a major public health priority.
Antimicrobial stewardship focuses on ensuring that patients receive the right medicine, in the correct dose and for the appropriate duration. It does not mean denying treatment to patients who genuinely need antibiotics. Instead, it aims to prevent unnecessary use while ensuring that bacterial infections receive timely and effective treatment.
Side effects can affect individual patients
Unnecessary antibiotics can also have an immediate impact on the person taking them. Possible side effects include nausea, diarrhoea, skin rashes, allergic reactions and interactions with other medicines.
Antibiotics can also disrupt the gut microbiome, the complex community of microorganisms that plays an important role in digestion and immune function. Disturbing this natural balance may increase the risk of certain opportunistic infections, including Clostridioides difficile, which can cause severe diarrhoea and colitis.
The risks vary depending on the medicine and the individual, but the possibility of adverse effects is another reason why antibiotics should not be taken without a clear medical need.
Coloured mucus does not always mean bacterial infection
A common misconception is that yellow or green mucus is proof of a bacterial infection. However, changes in the colour of nasal discharge can occur as part of the body’s normal immune response and do not, by themselves, establish the need for antibiotics.
Similarly, a cough that continues for some time after a cold does not automatically indicate that a bacterial infection has developed. Symptoms can persist even after the initial viral illness begins to improve.
Doctors generally consider the overall clinical picture, including the nature and severity of symptoms, medical history and signs of possible complications, before deciding whether antibiotic treatment is required.
Accurate diagnosis is key to proper treatment
Antibiotics remain essential medicines and should not be avoided when there is a suspected or confirmed bacterial infection. They may be required for conditions such as bacterial pneumonia, streptococcal sore throat, certain urinary tract infections and some complicated skin infections.
The key is to distinguish bacterial infections from viral and non-infectious conditions. Where necessary, microbiological tests and antimicrobial susceptibility testing can help identify the organism causing an infection and determine which medicine is likely to be effective.
ICMR guidelines also emphasise the importance of accurate clinical diagnosis and limiting empirical antibiotic therapy to situations where it is genuinely required. Proper diagnosis can help doctors select the appropriate treatment while reducing unnecessary exposure to antibiotics.
Patients have an important role
Patients can also help address antibiotic resistance by using medicines responsibly. Previously prescribed antibiotics should not be reused without medical advice, and people should not take medicines prescribed for someone else.
Antibiotic treatment should also not be started or stopped based solely on changes in symptoms without consulting a healthcare professional. When antibiotics are prescribed, patients should follow the doctor’s instructions regarding dosage and duration.
For illnesses where antibiotics are not required, symptom relief, adequate hydration, sufficient rest and regular monitoring may be more appropriate. People whose symptoms become severe, persist unexpectedly or worsen should seek medical advice rather than self-medicating.
Ultimately, the responsible use of antibiotics is about choosing the right treatment for the right illness. Taking an antibiotic for a viral cold or flu will not speed up recovery and may instead cause side effects and contribute to the spread of resistant bacteria.
As antimicrobial resistance continues to threaten the effectiveness of existing medicines, one simple question becomes increasingly important: Is the antibiotic really necessary? Ensuring that the answer is based on proper medical evaluation can protect patients today while helping preserve these vital medicines for the future.