Why wasn't I prescribed antibiotics?

Viral infections

Many common infections of the nose, throat, sinuses, ears and chest are caused by germs called viruses. Flu-like illnesses are also caused by viruses. Diarrhoea and/or being sick (vomiting) are often due to a viral infection of the gut. If you are normally well, your defence (immune) system is good at fighting off many types of viral infection. An antibiotic medicine is not needed if a virus is causing an infection. This is because:

• Antibiotics do not kill viruses. Antibiotics only kill germs called bacteria.

• Antibiotics may cause side-effects such as diarrhoea, rashes, feeling sick, etc.

• Overuse of antibiotics when they have not been necessary has led to some bacteria becoming resistant to them. This means that some antibiotics will not work when they are really needed.

See the separate leaflet called Treating Your Infection (Public Health England).

You may feel unwell for several days or more until a viral infection clears. Treatment aims to ease symptoms. Treatments that are commonly advised for viral infections include the following:

• Paracetamol or ibuprofen to reduce a high temperature (fever) and to ease aches, pains and headaches.

• Making sure you drink enough to prevent mild loss of water from the body (dehydration). Dehydration may develop if you have a high temperature and it can make a headache and tiredness much worse.

• Do not wrap up, but try to cool down if you have a high temperature. This is particularly important in children. If a child has a high temperature then take their clothes off (in a warm, but not hot, room) and consider giving some paracetamol or ibuprofen.

• Other advice may be given for specific symptoms. For example, decongestants for a blocked nose, etc. Ask a pharmacist for advice.

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Complementary and alternative medicine

Complementary and alternative medicine (CAM) is used by many people. It can have a very good effect on improving well-being and may be helpful in relieving some symptoms. However, although there is some evidence from clinical studies that CAMs may work for certain symptoms, the evidence is not very strong and it is impossible to draw firm conclusions about the benefits of each treatment. It is very important to consider whether any CAM treatment may have side-effects. Again the side-effects of some CAM treatments, particularly some herbal remedies, are not as well known as for conventional medicines. In addition, choosing to use alternative medicine instead of medically recommended treatments can sometimes be dangerous.

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What about bacterial infections?

The immune system can clear most infections caused by germs called bacteria. For example, antibiotic medicines usually do little to speed up recovery of bronchitis, or most ear, nose and throat infections that are caused by bacteria. However, you do need antibiotics if you have certain serious infections caused by bacteria, such as meningitis or pneumonia. When you are ill, doctors are skilled at checking you over to rule out serious illness and to advise if an antibiotic is needed.

If evidence and guidelines suggest that an infection will get better without an antibiotic, it is best not to use one unnecessarily. Excessive use of antibiotics results in the bacteria becoming used to them and adapting. If this happens, bacteria have become "resistant", which means the antibiotic no longer works against them. When this happens it means that doctors may have no useful treatment for infections which are serious and life-threatening

What if symptoms change?

Occasionally, mild infections caused by germs (viral or bacterial) develop into more serious infections. See a doctor to review the situation if the illness appears to change, becomes worse, does not go after a few days, or if you are worried about any new symptom that develops. If your illness has worsened, or if you have developed complications, it may be that you now do need an antibiotic. If this is the case, your doctor will prescribe an antibiotic if it is needed.

Occasionally you may be given a "back-up" prescription for an antibiotic to take if your condition gets worse. If this is the case, your doctor will give you instructions so you know in what situation you should start taking the medication. If you are not sure, call or see your doctor for advice.