Antibiotic use— viral vs bacterial infections

It’s just a virus…

Ok we get it. For most, it is easy when we medical professionals give you or your child a diagnosis and then an antibiotic treatment. It means that you should be feeling better within a few days, you know what monster you are dealing with, and exactly what to do for it. Nobody, including myself as a mom AND a medical provider, likes to hear, “it’s likely a virus.” This can sometimes just be, let’s be honest, annoying. When the words come out of my mouth when seeing patients, I know that I will likely be spending the next 5-10 min trying to convince the patient or parent WHY this is a good thing and why it is ok. 

As a mom, when I hear one of my children has a virus, I know it means I have to suck it up for a few more days and wait for things to improve without a specific treatment or specific diagnosis (YES, even nurses like me take our kids to the pediatrician’s office to be checked). Viruses like hand foot and mouth, or fifths disease get off easy, but hearing that you have the common cold virus, or a viral sore throat, just seems a little anticlimactic. 

By getting off easy I mean illnesses with a solid name, an identification, are much easier for a patient or family to accept than “just a virus.” Getting off easy does NOT mean these illnesses are easy! If you have had HFM, you will know this already! The good thing is that it really is BETTER for you or your child to avoid antibiotics, but it does mean it may not be cut and dried on how to treat their symptoms at home. 

One silver lining that I like to mention and remember, is that this also means we don’t have to deal with the fighting about taking medicine, remembering to take it for most likely TEN days, and the diarrhea that will probably come with that bubble gum flavored bottle of torture that we will endure for the next week and a half. So there is that! But let’s really talk about why we don’t want to use antibiotics unless they are truly needed.

Antibiotic resistance

Using too many antibiotics, most especially when we actually don’t need them, allows the bacteria to become smart, to mutate and to try and figure out how they can beat those antibiotics. This is NO BUENO. This means the antibiotics can no longer do their job. This is what we call becoming antibiotic resistant. When antibiotics are used too frequently, especially for things that don’t need antibiotics in the first place, it allows the bacteria to become smarter and more likely to be unaffected by the antibiotics that once killed them. 

One of the more common types of resistant bacteria seen in the community, which you may have heard of, is MRSA (Methicillin-resistant Staphylococcus aureus). It can be scary if you are exposed to MRSA, because it can be hard to treat. As the name states, these bacteria are resistant to some of the more common antibiotics, so a more broad coverage (big gun) antibiotic is needed to treat this kind of infection. 

This common household name is just one of many resistant infections. According to the CDC’s 2019 Antibiotic Resistance threats report, more than 2.8 million antibiotic-resistant infections occur in the U.S. each year, and more than 35,000 people die as a result! This is alarming. It is up to providers and patients to decrease the use of antibiotics and work together to achieve this result.

Avoiding antibiotics can be a good thing!

So here is the thing. For the most part, having a viral infection means that your illness will get better on its own. It means that you do not need an antibiotic. It means that you just have to trust in the magic of nature, and wait for symptoms to resolve. 

Here is what is important to think about. Most common viral infections last about 7-9 days. Fevers for these viral infections almost always go away after day 4 (ALL BY THEMSELVES). IF you have something bacterial that needs antibiotic treatment, you likely have been sick for at least a few days, let’s say 4-5. (Note– people with a fever lasting more than 4 days definitely need to be seen by a provider). Antibiotics usually take 2-3 days to work, so you will likely be feeling better around day around day 7. So in reality, viral infections, and treated bacterial infections, usually make you feel lousy for around the same time. On average, you start to turn the corner around the same time. It just SEEMS like the prescription of antibiotics fixes you quicker than the natural course of most common viral illnesses… Make sense? Did you follow that? This is usually the case and might make you feel better about that diagnosis of a virus. 

It may sound confusing BUT the take home point here is that it’s ok to have a virus that gets better on its own. Bacterial infections DO usually need an antibiotic to get better, but a virus does not. Keep reading for more specifics! 

Why can’t I get an antibiotic for a virus?

Antibiotics only make some bacterial infections better and will not make any viruses better. The CDC outlines the BEST way to use antibiotics

Did you know that some sinus and ear infections will clear on their own? Most will actually go away without an antibiotic. Viruses such as the common cold and most sore throats will also clear over time. A lot of us think that antibiotics are necessary to treat bronchitis, when in actuality, (surprise!) they are not always needed. Most of the time, you really don’t need an antibiotic. You need time, rest and some self care (things a lot of us don’t think of as treatment options). But make sure to be checked out if you have a fever, if your issue is getting worse or not improving, or if you are worried! We said sometimes you don’t need an antibiotic…but sometimes you do! 

Common bacterial illnesses requiring antibiotics 

There are a few common bacterial illnesses that will need an antibiotic. If you have Urinary tract infection, or whooping cough, then you will need an antibiotic for sure. Same goes if you have a positive strep test (strep throat). Then you will need an antibiotic to treat the strep throat. If you have a negative strep test, meaning the sore throat is caused by a virus, then the antibiotic will do NOTHING for the illness you have. If you take an antibiotic for a virus, it will do more harm than good. Antibiotics have a place, and are VERY important. You can read about sore throats or chat with us and decide if you should head in to see you provider or not. 

If you have an illness that seems to be getting worse, you aren’t feeling better, you have had a fever for more than 4 days, or you are concerned about your or your child’s health, it’s important to get checked out. You can also chat with us to help you to decide the right plan for you. 

We are just coming off world antibiotics week (yes it’s a thing). So there is a lot of great info out there on antibiotic use right now.

The Center for Disease Control has amazing helpful tips in helping you to protect yourself from these nasty antibiotic resistant bacteria:

  1. Tell your healthcare professional you are concerned about antibiotic resistance.
  2. Ask your healthcare professional if there are steps you can take to feel better and get symptomatic relief without using antibiotics.
  3. Take the prescribed antibiotic exactly as your healthcare professional tells you.
  4. Safely throw away leftover medication.
  5. Ask your healthcare professional about vaccines recommended for you and your family to prevent infections that may require an antibiotic.
  6. Never skip doses.
  7. Never take an antibiotic for a viral infection like a cold or the flu.
  8. Never pressure your healthcare professional to prescribe an antibiotic.
  9. Never save antibiotics for the next time you get sick.
  10. Never take antibiotics prescribed for someone else.

Antibiotics were considered to be a miracle drug in the first half of the 20th century. Penicillin, the first antibiotic for commercial use, was discovered in 1928. It saved countless lives, particularly during World War II, and is one of the most important medical discoveries of the last 100 years. However, overuse in recent years has led to an increase in diseases that are resistant to antibiotics. You can play a big part in reversing this trend by following the tips in this article. Take control of your health. Ask questions. Work with your health care provider to make the right decisions together. And always feel free to chat with us if you have questions. 

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a nurse hotline to ask a few questions. Questions like, how to stop pertussis, or whooping cough, in babiesIs the Hep A vaccine safeHow to prevent UTIs in men? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.