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In the past few years, Americans have been getting slightly fewer prescriptions for antibiotics. According to a 2017 report from the Centers for Disease Control and Prevention, those prescriptions fell by a few percentage points from 2011 to 2014, a trend driven mainly by a drop in "scripts" for kids. Still, the CDC estimates that every year 47 million prescriptions for antibiotics that are written in doctors’ offices and emergency departments aren’t necessary. 

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Most of these prescriptions are for respiratory illnesses such as colds and flu, the kinds of ailments that commonly occur during the winter.

But antibiotics work only against bacterial infections. Colds and flu are “viral conditions for which antibiotics are not needed at all,” says Katherine Fleming-Dutra, M.D., deputy director of the CDC’s Office of Antibiotic Stewardship. And not only are antibiotics ineffective for viral infections, but they can also have significant downsides, especially when used for the wrong reasons.

Here’s why it’s unwise to ask for antibiotics for colds and flu, and the steps that can help you feel better if you're sidelined by these viral infections.

Using Antibiotics Can Backfire

Antibiotics can help cure bacterial infections but also cause serious side effects, such as rashes, nausea, diarrhea, and yeast infections. And they can cause allergic reactions.

These drugs can also raise your risk of infection with C. difficile, which can cause severe diarrhea. And in some cases, it can be life-threatening.

Older adults may be especially susceptible to C. difficile infections, in part because their immune systems may be less robust than a younger person’s, says Yonatan Grad, M.D., Ph.D., an assistant professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health, and author of a recent study on the overprescription of antibiotics to older adults.

In addition, taking an antibiotic can increase your chance of coming down with an antibiotic-resistant infection, a bacterial infection that’s less responsive to the drugs.

Doctors may prescribe antibiotics too often, at least in part, because they feel pressured by patients seeking a cure from respiratory ailments, says Fleming-Dutra. So if you see a doctor for a bug this winter, let him or her know that you don’t want to be prescribed an antibiotic unless you absolutely need it for a bacterial infection such as pneumonia or strep throat.

Take These Steps Instead

For colds and the flu, getting plenty of rest and drinking fluids are key. Here’s what else can help ease discomfort: 

For the flu. Try over over-the-counter medications such as acetaminophen (Tylenol and generic), ibuprofen (Advil and generic), or naproxen (Aleve and generic) to keep your fever down and combat aches and pains.

Some people may benefit from prescription antiviral drugs. Oseltamivir (Tamiflu and generic) can shorten the time you feel sick with the flu by about a day. The newly approved baloxavir marboxil (Xofluza) appears to have similar benefits. Both should be taken taken within 48 hours of experiencing symptoms for maximum effectiveness.

It’s especially important to ask your doctor for an antiviral drug if you’re at high risk of developing serious flu complications. That includes young children, older adults, pregnant women, and people with underlying medical problems such as asthma, heart disease, or lung disease.

And if you start to feel better from flu but then suddenly start feeling sick again and spike a new fever and cough, call your doctor immediately. This is a sign that you may have developed pneumonia and may need antibiotics. Here's how to know whether you need emergency help for the flu. 

For a cold. OTC pain relievers can help with the sore throat that often accompanies a cold. Gargling warm salt water (mix ½ to 1 teaspoon of salt into an 8-ounce glass of water) can also be soothing. For congestion, you can try OTC meds such as the decongestant pseudoephedrine (Sudafed and generic). But home remedies will also help; consider nasal saline rinses in the form of saline sprays or neti pots. And don’t underestimate the power of a bowl of chicken soup. Research suggests it can actually help you feel better.