Antibiotics and the Common Cold


Are antibiotics appropriate therapy for the common cold?
Emilie Osborn - Associate Dean - UCSF School of Medicine - San Francisco, California

Dr. Greene's Answer

This is an extremely important question! There are over one billion colds in the United States annually, with each child averaging 3 to 8 colds per year. It is no fun when your child has a cold.

Antibiotics are one of the most revolutionary discoveries of the 20th century. Since their introduction in 1941, they have relieved and prevented incalculable suffering. In the right setting, antibiotics are a powerful, lifesaving tool. What is their role in treating the common cold?

Most people vaguely lump viruses and bacteria together in their minds. Let’s take a closer look at the teeming microscopic world.

Viruses are tiny geometric structures that can only reproduce inside a living cell. They range in size from 20 to 250 nanometers (one nanometer is one billionth of a meter). Outside of a living cell, a virus is dormant, but once inside, it takes over the resources of the host cell and begins the production of more virus particles. Viruses are more similar to mechanized bits of information, or robots, than to animal life.

Bacteria are one-celled living organisms. The average bacterium is 1,000 nanometers long (If a bacterium were my size, a typical virus particle would look like a tiny mouse-robot. If an average virus were my size, a bacterium would be the size of a dinosaur over ten stories tall. Bacteria and viruses are not peers!). All bacteria are surrounded by a cell wall. They can reproduce independently, and inhabit virtually every environment on earth, including soil, water, hot springs, ice packs, and the bodies of plants and animals.

Most bacteria are harmless to humans. In fact, many are quite beneficial. The bacteria in the environment are essential for the breakdown of organic waste and the recycling of elements in the biosphere. Bacteria that normally live in humans can prevent infections and produce substances we need, such as vitamin K. Bacteria in the stomachs of cows and sheep are what enable them to digest grass. Bacteria are also essential to the production of yogurt, cheese, and pickles. However, some bacteria cause infections in humans. In fact, they are a devastating cause of human disease.

Colds are caused by viruses, not bacteria. Over 200 different species of virus causing the common cold have been identified.

Antibiotics do not work at all in treating the common cold. A net designed to trap a human could let a tiny mouse escape. Antibiotics are medicines that kill bacteria, not viruses. Many antibiotics work by disrupting the bacteria’s cell wall. Viruses don’t even have a cell wall.

Antibiotics can actually make colds worse. By indiscriminately killing the beneficial bacteria, an environment more hospitable to the cold viruses is created.

To make matters worse, all antibiotics have side effects. All antibiotics harm beneficial bacteria, and can cause diarrhea, yeast infections, and bacterial super-infections. Even something as ‘mild’ as amoxicillin has been known to cause bone marrow toxicity, seizures, acute interstitial nephritis, neuromuscular sensitivity, nausea, vomiting, urticarial rashes, pseudomembranous colitis, thrombocytopenic purpura, anaphylactic shock, and even death.

If the one billion colds in the U.S. this year were ‘treated’ with antibiotics, billions of dollars would be spent, at least 100 million people would suffer from side effects, some would even die, and ZERO people would have their cold end quicker or even have milder symptoms.

If you want to buy a lottery ticket for your child, choose one with a better prize.

The greatest danger of using antibiotics to treat the common cold is the emergence of resistant bacteria. Over time, the bacteria in your community will develop resistance to the antibiotics most commonly used there. Then, when your child really needs them, antibiotics, the once powerful defenders, will be a shadow of their former strength.

Last medical review on: October 26, 2010
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
Get Dr. Greene's Wellness RecommendationsSignup now to get Dr. Greene's healing philosophy, insight into medical trends, parenting tips, seasonal highlights, and health news delivered to your inbox every month.
Add your comment

Recent Comments

Hello! I found this article through a search. I’m having a lot of worry about my son being put on antibiotics for an abscess on his tooth. He is 4. Coincidentally, we have a viral cold running through our house and now I’m even more worried we are wiping out his good guys at a time he needs them! Thankfully, he is still getting breast milk, but I’m not even sure how well that’s doing with the antibiotics. He seems like he’s getting sick, our 11 month old is sick with a fever, I was very sick for a day. It was a strong battle! And I’m wiping out his immune system! I’m afraid to stop in the middle of the prescription. And he’s going to have to get that tooth pulled out next week. I just hope I’m doing the right thing. The last thing I want to be doing is hurting my child…