December 30, 2005

Understanding the Common Cold

By Eduardo Grunvald, M.D.

Winter is upon us and so is the common cold. You know the symptoms. Sore throat, headaches, cough, runny nose, congestion, sneezing, muscle aches, and fevers... just to name a few.

You take time off from work to see your doctor. If you’re lucky enough to get an appointment, you sit in the waiting room for half an hour. Then you sit in the exam room for another fifteen minutes. After lots of questions, prods and pokes, the doctor tells you that antibiotics will not help you. 

All that effort for nothing?

How about all the left over prescriptions from last season? Why not just take those?

Is this convenience worth the potential consequences? Could you really do more harm than good?

To answer that question, one must better understand a “cold”.

A “cold” is simply a virus infection of the lining of your respiratory system. It can be an infection of your nose, your sinuses, your throat, or the airways in your lungs. While bacteria can also cause these illnesses, the vast majority are from viruses.

What about the flu? This is an exception... sort of. The flu is caused by a virus called influenza. There are medications - called antivirals - that can shorten the duration of the illness if started within two days of the start of symptoms, but these are not considered traditional antibiotics.

What do antibiotics do? Antibiotics kill bacteria. They do not even harm viruses. Most “colds” go away by themselves. Even bronchitis in healthy adults will likely resolve without treatment.

But what is the harm of taking antibiotics?

There exists the unpredictable risk of allergies and adverse reactions, which, although rare, can be serious.

More importantly from a public health perspective however, is the rise of resistance.  Let’s say you use antibiotics fre-quently. Eventually, the “strongest” bacteria - or the ones that are not killed by the medication - will survive. When these germs do cause serious infections, the commonly used antibiotics will not be effective. This phenomenon is already a problem in most hospitals and could harm you the next time you come down with an infection.

Last but not least, there is unnecessary cost when these medications are used inappropriately.

This is not to say your doctor cannot help you find relief from those miserable symptoms. Different medications —whether prescription or over-the-counter— can target a nagging cough, a pesty runny nose, or a scratchy throat. This is what we call symptomatic treatment. Your body will naturally fight off the viral intruders.

So next time you get sick and your doctor does not recommend antibiotics, remember that you are saving powerful weapons until you really need them. 

Dr. Grunvald is Assistant Clinical Professor, Department of Medicine at the Perlman Internal Medicine Group, UCSD Medical Center.

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