You may notice a change at the doctor's office this winter, as the U.S. healthcare system steps up its efforts to preserve an entire class of infection-fighting drugs.

Respiratory infections are the most common reason people go to the doctor, and those patients often leave with a prescription for an antibiotic. Problem is, about half those prescriptions aren't needed, according to the Centers for Disease Control and Prevention.

Upper respiratory infections almost always are caused by a virus—but antibiotics only work against bacteria. “These drugs have zero effect on viruses,” says Marvin M. Lipman, M.D., Consumer Reports' chief medical adviser.

And while antibiotics have a reputation as being harmless, one in four people taking the drugs experience diarrhea, rashes, or other side effects. Other consequences include allergic reactions that send thousands of people to the emergency each year and millions of dollars in wasted healthcare spending, according to the CDC.  

What’s more, unrestrained use of the drugs has promoted the rise of dangerous superbugs—strains of bacteria that have acquired resistance to multiple antibiotic drugs.

At least 2 million people in the U.S. each year are now infected with bacteria that can’t be easily treated with antibiotics. These resistant bacteria kill about 23,000 people each year, and indirectly lead to the deaths of many more.

Last week, in a joint paper, the CDC and the American College of Physicians issued updated advice to doctors on smarter ways to treat people who have a respiratory infection.

When to Use Antibiotics

The recommendations urge doctors to level with their patients, explain the likely course of the viral infection, and cut way back on antibiotics:

  • For the common cold: Doctors should not prescribe them.
  • For a typical chest cold (bronchitis): Doctors should not prescribe antibiotics unless they suspect the patient has pneumonia.
  • For a sore throat: Doctors should use antibiotics only if a test has confirmed that the patient has strep throat, which is a bacterial infection.
  • For an uncomplicated sinus infection: Doctors should use antibiotics only for persistent, severe, or worsening cases.

What to Do Instead

If  you have a respiratory infection, Consumer Reports recommends these steps for easing your symptoms while your body is fighting the infection.

  • Get plenty of rest and drink lots of fluids.
  • Use a humidifier (and clean it daily).
  • Ease pain and reduce fever with acetaminophen (Tylenol and generic) and ibuprofen (Advil and generic).
  • For nasal discomfort, use saline (salt water) drops or spray.
  • To soothe a sore throat, gargle with salt water, drink warm beverages, or eat or drink something cool.
  • To ease a cough, breathe steam from a kettle or shower. For mild, short-term relief, try an over-the-counter cough medicine that has dextromethorphan.

For More Information

What can you do to protect yourself and to help reduce antibiotic overuse? Here are some resources: