Colds: commonsense not antibiotics

The National Prescribing Service (NPS) — a non-profit, independent organisation working to improve the health of Australians through appropriate use of medicines — offers some commonsense advice for coping with colds and flu.

Colds are not flu

People commonly talk about ‘having the flu’ when they are actually suffering from a cold. Colds and flu are both caused by viruses, however, the flu — influenza — is a serious illness that does result in deaths every year. The common cold rarely causes serious harm.

The difference between colds and flu

The symptoms of flu usually start suddenly with a high fever, and people often feel so unwell that they take to their bed straightaway. The onset of a common cold is usually slower and the symptoms are usually restricted to the nose and throat. Flu symptoms, however, may include irritation in the throat or lungs, a dry cough, shivering, sweating, and muscle aches that tend to affect the whole body.

Common cold symptoms include sneezing, coughing, a sore throat and a blocked or runny nose. If fever is present, it is usually mild. Most common colds get better in 7 to 10 days, although the cough may last 1-2 weeks longer than other symptoms. Green or yellow mucus may come from the nose which shows that the immune system is fighting the infection. It does not necessarily mean that your cold is getting worse or that you have a bacterial infection and need antibiotics.

How is the common cold spread?

Common colds are caused by infectious agents called viruses. The viruses can be spread from people's hands and objects such as toys, door handles and tissues, and by breathing in droplets from sneezes or coughs.

How can you avoid getting the flu or common cold?

  • Practise preventative measures: wash your hands with soap, especially after blowing your nose or when eating or preparing food.
  • Keep your fingers away from your eyes, nose and mouth.
  • Cover your mouth when sneezing or coughing.
  • Blow your nose on paper tissues and dispose of them after use.
  • Avoid sharing cups, glasses and cutlery.
  • Avoid close contact with cold sufferers.

Will antibiotics help a cold to get better faster?

Antibiotics only work on infections caused by bacteria and have no effect on viruses. So antibiotics have no effect on cold and flu viruses — your immune system has to fight these viruses. Antibiotics won’t stop your cold from getting worse and will not stop infection spreading to other people. Importantly, using antibiotics when you don’t need them may make them less effective when you do need them. Antibiotics may cause side effects like stomach upsets, diarrhoea, thrush, and allergic reactions.

Ear and throat infections may be caused by bacteria or viruses. When they are caused by bacteria, antibiotics may have a place in treatment. Some examples include: middle ear infection (otitis media), which can cause severe earache in children; severe tonsillitis; and sinusitis, which may cause facial pain and a thick discharge from the nose. However, these illnesses also tend to get better by themselves, and antibiotics are needed only in some cases. Antibiotics may be needed more often in Aboriginal and Torres Strait Islander people as they are more likely to develop complications from respiratory tract infections.

Practical ways to relieve the symptoms of common colds and flu

Take it easy

Help your immune system: get plenty of rest and drink lots of fluids. Also, avoid exposure to cigarette smoke.

Clearing mucus, blocked sinuses or a runny nose

  • Saline. Salt water sprays and drops can help clear mucus.
  • Steam inhalation. Inhale steam from the shower or breathe in steam from a bowl of hot water (not boiling) with a towel over your head. Children should avoid inhaling steam from a bowl due to the risk of burns from the steam or from the water spilling.
  • Decongestants. These come as sprays, drops, tablets or a mixture, and can help dry up a runny nose or relieve blocked sinuses. Check the label to make sure it's safe to use a decongestant, especially for children and pregnant and breastfeeding women. Prolonged use of decongestants (more than 5-7 days) should be avoided.

Soothing a sore throat

  • Gargle with warm, salty water or suck an ice cube or a throat lozenge.
  • Pain-relieving medicines such as paracetamol, ibuprofen or aspirin may ease the pain of a sore throat. Check the label to ensure the medicine is suitable. Remember NEVER to give aspirin to anyone under 18 years of age unless prescribed by your doctor, as it can (rarely) cause serious harm.

Using vitamins, minerals, herbals and natural medicines

All medicines, including herbal or ‘natural’ medicines, can have unwanted effects and interactions with other medicines. In addition, herbal and natural medicines may not have been tested in the same way as prescription medicines.

  • For children. There is insufficient quality evidence to show benefits in using vitamins, minerals or herbals in treating colds in children. Also, children can have side effects from using these medicines.
  • For adults. Vitamin C seems unlikely to reduce the duration or severity of cold symptoms, and has not been shown to prevent colds. Zinc lozenges have not been shown to shorten the length of a cold or symptom severity and they can have side effects. Echinacea preparations differ greatly; most have not been tested in good-quality clinical trials. Echinacea has not been shown to help prevent or treat colds.

See your doctor if it gets worse

If you have other health conditions, such as asthma or diabetes, that worsen during a cold, see your doctor. If symptoms come on suddenly, or are severe or last longer than usual, see your doctor.

If you or your child experiences any of the following symptoms, see your doctor:

  • temperature higher than 38.5 degrees Celsius or chills;
  • neck stiffness;
  • severe headache;
  • light hurting the eyes;
  • chest pain;
  • shortness of breath, noisy or fast breathing, or difficulty breathing;
  • skin rash;
  • pale or mottled skin;
  • vomiting;
  • difficulty waking up or unusual drowsiness;
  • persistent cough; or
  • aching muscles.

If a child or baby develops any of the following symptoms, see a doctor:

  • bulging of the fontanelle (soft spot on the top of the baby's head);
  • high temperature in babies under 6 months of age;
  • excessive irritability;
  • breathing difficulties;
  • a strange high-pitched cry;
  • lack of energy;
  • floppy limbs;
  • cold, blue or pale hands or feet;
  • loss of appetite/not drinking or feeding properly; or
  • earache.

For more information

  • Talk to your doctor or pharmacist.
  • Telephone the NPS Medicines Line on 1300 633 424, Monday to Friday, 9 am to 5 pm Australian Eastern Standard Time, for confidential, independent information about medicines for consumers.
Last Reviewed: 9 November 2009
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References

1.National Prescribing Service [website]. Common colds need common sense, not antibiotics (updated 2008, May). Available at: http://www.nps.org.au/consumers/campaigns/ccncs/brochure
2. Arroll B. Common cold. Clinical Evidence [online] 2008 [cited Jun 9]. URL: http://clinicalevidence.bmj.com/ (accessed 2009. Nov 13)
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