Summary
The common cold is a viral respiratory infection primarily caused by the Rhinovirus. It targets the upper respiratory tract, particularly the nose and throat, manifesting symptoms such as a runny nose, cough, and headaches. Unlike bacterial infections, colds do not respond to antibiotics, as these medications are designed to combat bacteria, not viruses. The misuse of antibiotics when dealing with a viral infection like the common cold can lead to antibiotic resistance, a serious public health concern. Instead, managing cold symptoms through rest, hydration, and over-the-counter remedies is the recommended course of action for otherwise healthy individuals. Additionally, humidifying the air can soothe the respiratory tract by adding moisture to the environment. In certain severe cases, antiviral medications might be prescribed. However, antibiotics should only be considered if symptoms persist beyond 7 to 10 days or if there is a noticeable ‘double worsening’—an initial improvement followed by a sudden aggravation of symptoms. A proper understanding and management of cold symptoms are crucial to avoid unnecessary antibiotic use and to support effective recovery strategies.
Keywords: Common Cold Remedies; Antibiotic Resistance Awareness; Viral Infection Treatments; Rhinovirus Symptoms; Cold Prevention Tips
What is a cold?
A cold is an infection that affects the nose and throat, most commonly caused by viruses. There are over 200 species of viruses that can cause a cold, with the most widespread being the Rhinovirus, accounting for 10 to 40 percent of cases. Other viruses such as respiratory syncytial virus and parainfluenza contribute to around 20 percent of colds. In most cases, a common cold is a viral infection, and bacterial coinfections (simultaneous infection with multiple pathogens) are very rare. Antibiotic treatment is not necessary for healthy young adults.
Who is at a higher risk for the common cold?
Everyone is at risk for the common cold, but certain factors can increase the likelihood of catching one. Colds are more common during the winter months, likely due to the dry air which can make the nasal passages more susceptible to infection. Stress and allergies can also weaken the immune system, making individuals more vulnerable to colds. Children tend to experience more colds than adults, possibly due to their developing immune systems.
What are some symptoms that are seen in a common cold?
Runny and stuffy nose
Sneezing
Weakened sense of taste and smell
Scratchy and itchy throat
Cough
Watering eyes
Low grade fever (95 degrees Fahrenheit to 100.3 degrees Fahrenheit)
Achy muscles and bones
Chills
Headaches
Watery discharge from the nose that thickens and turns yellow or green.
These symptoms look simple but can disrupt our day to day lives which makes antibiotics like azithromycin so tempting. But do these antibiotics really help us with a viral infection?
Why are antibiotics not useful in a viral infection?
Antibiotics are effective against bacterial infections because they target and kill bacteria, which are small organisms that can cause disease. Many of these bacterias are part of our normal flora and are beneficial under normal conditions, such as gut microbiota that help digest food. However, viruses are fundamentally different from bacteria. Bacteria typically attack cells from the outside, while viruses enter and live inside cells. Viruses cannot reproduce on their own and instead rely on healthy cells to replicate.
Because antibiotics are designed to target bacteria specifically, they have no effect on viruses. Taking antibiotics unnecessarily, such as for a viral infection like the common cold, can contribute to the disruption of our normal flora and even antibiotic resistance. This occurs when bacteria adapt and become resistant to the effects of antibiotics, making infections more difficult to treat.
Medical experts are concerned about the rise of antibiotic resistance, as it limits the effectiveness of antibiotics and poses a significant threat to public health. Using antibiotics only when necessary and as prescribed by a healthcare professional is essential to combat antibiotic resistance and avoid unnecessary risks and side effects.
What can we do instead of taking antibiotics for relief?
Instead of taking antibiotics for relief from viral infections like the common cold, it's important to focus on supportive care. Resting in bed, staying hydrated by drinking plenty of fluids, and taking over-the-counter medications to alleviate symptoms such as fever, body aches, headaches, cough, and nasal congestion can help you recover from a virus. Humidifying the air can also be beneficial, as it helps keep the environment moist, which can ease symptoms. For severe cases, a general practitioner may prescribe antiviral medications to reduce the severity and duration of the illness. However, these medications are typically reserved for specific viral infections and are not routinely used for common colds.
When can we take an antibiotic for the common cold?
The decision to use antibiotics for the common cold is based on specific criteria, primarily the duration of symptoms. According to the American Academy of Otolaryngology guidelines for acute sinusitis, symptoms should persist for more than 7 to 10 days before a bacterial infection is considered. Typically, symptoms of the common cold can last up to two weeks, with cough and post-nasal drip being the last symptoms to resolve.
An exception to the 7 to 10-day rule is if someone with what they believe to be a common cold starts to improve but then experiences a "double worsening" of symptoms. If this occurs before 7 days, it may indicate a bacterial infection, and antibiotics should be considered under the supervision and prescription of a physician.
Author: Dr. Ananya Chekragari, MBBS, Trinity School of Medicine, Ratho Mill, Saint Vincent and the Grenadines.
Editor: Dr. Sidhant Ochani, MBBS, Khairpur Medical College, Khairpur, Pakistan.
References
Dr. Satish Govindaraj, Jun 30, 2022, Are Antibiotics Necessary for the Common Cold? https://health.mountsinai.org/blog/are-antibiotics-necessary-for-common-cold-2/
Sandy Pruthi, M.D, Jun 03, 2022, Cold remedies: What works, what doesn't, what can't hurt?https://www.mayoclinic.org/diseases-conditions/common-cold/in-depth/cold-remedies/art-20046403
Queensland Health, March 22 2023, Why antibiotics can't be used to treat your colds, flu, and other viral illnesses. https://www.health.qld.gov.au/newsroom/news/antibiotics-viruses-cold-flu
American Lung Association, Jan 22 2024, Facts About the Common Cold. https://www.lung.org/lung-health-diseases/lung-disease-lookup/facts-about-the-common-cold
Very informative. Thank you for making this understandable to a common man.