Should I take antibiotics for flu and colds?

Any graduate medical professional has a firm knowledge of the fact that antibiotic therapy for colds and flu is absolutely meaningless. Local doctors and doctors practicing in hospitals are aware of this. However, antibiotics are prescribed, and often do so as a preventive measure. After all, a patient who has turned to a doctor expects treatment from him.

If you ask the doctor whether to drink an antibiotic for flu and colds, then the answer will be unambiguously negative. All treatment for ARVI comes down only to drinking plenty of water, bed rest, taking vitamins, good nutrition, cleansing the nose, gargling, inhalations and symptomatic therapy. Antibacterial drugs are not required, but often the patient himself insists on them, literally asking the doctor for an appointment.

In pediatric practice, antibacterial drugs are often prescribed for the purpose of reinsurance, so that a bacterial complication does not occur against the background of a viral infection. Therefore, the doctor recommends an effective drug to parents, calling it a “children’s” antibiotic, in order to protect themselves from unnecessary questions. However, complications can be avoided simply by giving the child a drink in time, moistening the air he breathes, washing his nose and applying other symptomatic treatment. The body, with such adequate support, will cope with the disease on its own.

The question is quite natural as to why the pediatrician still prescribes an antibacterial drug for influenza and SARS. The fact is that the risk of complications of colds and flu in preschoolers is actually very high. Their immune defense is imperfect, and their health is often undermined by malnutrition, poor environmental conditions, etc. Therefore, if a complication develops, only the doctor will be to blame. It is he who will be accused of incompetence, even prosecution and loss of work is not ruled out. This is what leads many pediatricians to recommend antibiotics in cases where they could be dispensed with.

An indication for the appointment of antibiotics is the addition of a bacterial infection, which is a complication of influenza and colds. This happens when the body is unable to fight off the virus on its own.

Whether it is possible to understand under analyzes, what antibiotics are necessary?

It is, of course, possible to understand from the analyzes that antibacterial treatment is required.

However, they are not done in every case:

• The collection of urine or sputum for culture is an expensive test, in which polyclinics seek to save the available budget;

• Most often, a smear is taken from the nasal cavity and pharynx with a diagnosed sore throat. A swab is taken on a Lefler stick, which is the cause of the development of diphtheria. Also, doctors can refer the patient to take a swab from the tonsils for bacterial culture if the patient is haunted by chronic tonsillitis. Another common analysis is selective urine culture for pathologies of the urinary system;

• An increase in ESR and the level of leukocytes, as well as a shift in the leukocyte formula to the left, is an indirect sign that bacterial inflammation occurs in the body. You can see this picture by a clinical blood test.

How to understand by well-being that complications have arisen?

Sometimes you can even understand that a bacterial complication has arisen on your own.

This will be indicated by the following signs:

• The secret that is separated from the ENT organs or from the eyes becomes cloudy, turns yellow or green. Normally, the discharge should be transparent;

• First there is an improvement, and then the temperature rises again. The second jump in body temperature should not be ignored;

• If bacteria attack the urinary system, then the urine becomes cloudy, sediment may be found in it;

• If a bacterial infection has affected the intestines, then mucus or pus will be present in the stool. Sometimes even blood impurities are found, depending on the severity of the infection.

As for acute respiratory viral infections, the addition of bacterial flora can be suspected by the following signs:

• Against the background of an already diagnosed cold, there was an increased body temperature, which began to decrease on the 3rd-4th day, but then jumped again to high levels. Most often this happens on the 5th-6th day of illness, and the general state of health again deteriorates sharply. Cough becomes stronger, shortness of breath occurs, pain in the chest appears. Most often, this condition indicates the development of pneumonia. See also: symptoms of pneumonia;

• Diphtheria and tonsillitis are also common complications of SARS. You can suspect their onset by sore throat, which occurs against the background of increased body temperature, a layer of plaque forms on the tonsils. Sometimes there are changes in the lymph nodes – they increase in size and become painful;

• Discharge from the ear and the appearance of pain that increases when the tragus is pressed are signs of otitis media, which often develops in young children;

• If the pain is localized in the forehead area, in the face area, the voice becomes nasal and rhinitis is observed, then sinusitis or sinusitis should be excluded. Such a sign as an increase in pain when the head is tilted forward and loss of smell can confirm the suspicion.

If a bacterial complication is suspected, it is quite possible due to the symptoms of the disease and the deterioration of well-being, then only a specialist can choose a specific antibacterial agent.

This is influenced by many factors, including:

• Localization of inflammation;

• The age of the patient;

• Medical history;

• Individual intolerance to a particular remedy;

• Resistance of the pathogen to antibacterial drugs.

When antibiotics are not indicated for a cold or uncomplicated SARS?

• Rhinitis with purulent-mucous discharge, which lasts less than 2 weeks;

• Viral conjunctivitis;

• Tonsillitis of viral origin;

• Rhinopharyngitis;

• Tracheitis and mild bronchitis without high body temperature;

• Development of a herpetic infection;

• Inflammation of the larynx.

When is it possible to use antibiotics for uncomplicated acute respiratory infections?

• If there are disturbances in the functioning of the immune defense, as indicated by specific signs. These are conditions such as HIV, cancer, constantly elevated body temperature (subfebrile temperature), viral infections that occur more than five times a year, congenital disorders in the immune system.

• Diseases of the hematopoietic system: aplastic anemia, agranulocytosis.

• If we are talking about a child up to six months, then he will be recommended to take antibiotics against the background of rickets, with insufficient body weight and with various malformations.

Indications for the appointment of antibiotics

Indications for the appointment of antibiotics are:

• Angina, the bacterial nature of which has been confirmed by laboratory tests. Most often, therapy is carried out with the use of drugs from the group of macrolides or penicillins. See also: antibiotics for angina for an adult;

• Bronchitis in the acute stage, laryngotracheitis, relapse of chronic bronchitis, bronchiectasis requires taking antibiotics from the macrolide group, for example, Macropen. To rule out pneumonia, a chest x-ray is required to confirm pneumonia;

• Taking antibacterial drugs, visiting a surgeon and a hematologist requires a disease such as purulent lymphadenitis;

• An otolaryngologist’s consultation regarding the choice of drugs from the group of cephalosporins or macrolides will be necessary for patients with diagnosed otitis media in the acute stage. The ENT doctor also treats diseases such as sinusitis, ethmoiditis, sinusitis, which require the appointment of an adequate antibiotic. It is possible to confirm such a complication by X-ray examination;

• Therapy with penicillins is indicated for pneumonia. At the same time, the strictest control of the therapy and confirmation of the diagnosis with the help of an X-ray image is mandatory.

Very indicative in terms of inadequate prescription of antibacterial agents is a study that was conducted in one of the children’s clinics. Thus, an analysis of medical records of 420 children of primary preschool age revealed that 89% of them had ARVI or acute respiratory infections, 16% had acute bronchitis, 3% otitis media, 1% pneumonia and other infections. At the same time, antibiotic therapy was prescribed in 80% of cases for viral infections, and for bronchitis and pneumonia in 100% of cases.

Pediatricians have been found to be aware that viral infections cannot be treated with antibiotics, but still prescribe antibiotics for reasons such as:

• Installation guide;

• Children under 3 years of age;

• The need to prevent complications;

• Lack of desire to visit the kids at home.

At the same time, antibiotics are recommended to be taken for 5 days and in small doses, and this is dangerous in terms of the development of bacterial resistance. In addition, there are no test results, so it is not known which pathogen caused the disease.

Meanwhile, in 90% of cases, viruses were the cause of malaise. As for bacterial diseases, they were most often provoked by pneumococci (40%), Haemophilus influenzae (15%), staphylococci and mycotic organisms (10%). Microorganisms such as mycoplasmas and chlamydia rarely contributed to the development of the disease.

You can take any antibacterial drugs only after medical consultation. Only a doctor can competently determine the appropriateness of their appointment after collecting an anamnesis, taking into account the age of the patient and the severity of the pathology.

You can use the following antibacterial agents:

• Preparations of the penicillin series. Semi-synthetic penicillins are recommended in the absence of allergies to them. It can wash Amoxicillin and Flemoxin Solutab. If the disease is severe, then experts recommend taking protected penicillins, for example, Amoxiclav, Augmentin, Flemoclav, Ecoclave. In these preparations, amoxicillin is supplemented with clavulanic acid;

• macrolide antibiotics used to treat pneumonia and respiratory infections caused by chlamydia and mycoplasmas. This is Azithromycin (Zetamax, Sumamed, Zitrolid, Hemomycin, Azitrox, Zi-factor). With bronchitis, the appointment of Macropen is possible;

• From cephalosporin drugs it is possible to prescribe Cefixime (Lupin, Suprax, Pantsef, Ixim), Cefuroxime (Zinnat, Aksetin, Zinacef), etc.;

• From the fluoroquinolone series prescribe drugs Levofloxacin (Floracid, Glevo, Hailefloks, Tavanik, Flexid) and Moxifloxacin (Moksimak, Pleviloks, Aveloks). Children in this group of drugs are never prescribed due to the fact that their skeleton is still being formed. In addition, fluoroquinolones are drugs that are used in especially severe cases, and they represent a reserve to which the bacterial flora of a grown child will not be resistant.

Main conclusions

• Using antibacterial drugs for a cold that is of viral origin is not only pointless, but also harmful. They are needed to treat a bacterial infection.

• Antibacterial drugs have a wide list of side effects: they can negatively affect the functioning of the liver and kidneys, can provoke the development of allergies, have a depressing effect on the immune system, and disrupt the normal microflora in the body.

• For prophylactic purposes, the use of antibacterial drugs is unacceptable. It is important to monitor the patient’s condition and prescribe antibiotics only if an antibacterial complication actually occurs.

• An antibacterial drug is ineffective if the body temperature does not decrease after 3 days from the start of its administration. In this case, the tool must be replaced.

• The more often a person takes antibiotics, the faster the bacteria will develop resistance to them. Subsequently, this will require the appointment of more serious drugs that have a detrimental effect not only on pathogenic agents, but also on the body of the patient himself.