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Health & Wellness

Cold or Flu? Don’t Ask for Antibiotics

They won’t help, and can hurt


Adding their voices to a national campaign, BU health officials are greeting flu and cold season with a warning against using unnecessary antibiotics.

Most illnesses in the chilly-and-dark months come from viruses, and antibiotics cure bacterial, rather than viral, infections, says David McBride, director of Student Health Services. That means that all those colds, flus, runny noses, nonstrep sore throats, and most coughs and bronchitis that students bring to the infirmary can’t be helped with antibiotics.

“We do often see students and their families who are accustomed to calling their doctor and getting a prescription for antibiotics over the phone,” says McBride. He notes that for the most routine sinus infection (sinus infections being a common student complaint at this time of year), studies have shown that “placebo and antibiotics do about the same in terms of the person getting better.”

With Student Health Services treating thousands of upper respiratory tract infections every year, he says, “we want to practice good, evidence-based medicine.”

And the evidence is that “antibiotics are vastly overprescribed,” says Wayne LaMorte, a professor at both the School of Medicine and the School of Public Health. “A large proportion of the inappropriate prescriptions result from upper respiratory tract infections,” especially during this time of year.

“Antibiotics have no effect whatsoever on viral infections,” LaMorte says. It’s not just a problem of doing no good; needless antibiotics may do harm. “There can be side effects from any medication, including antibiotics, and there is no value in being exposed to a medication one doesn’t need,” says M. Anita Barry, director of the Boston Health Commission’s Infectious Disease Bureau. And rampant antibiotics use has increased drug-resistant bacteria, leading to what the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS) say has become a “critical threat to the public health of the United States.”

“We at Student Health Services have seen an increase in the incidence of antibiotic-resistant bacterial infection,” McBride says. That issue isn’t confined to campus, but is “a major problem in the United States and throughout the world,” says Barry. “Some bacteria are becoming increasingly resistant to our currently available antibiotics, and relatively few new antibiotics are in the development pipeline.”

Washing your hands for an entire minute—longer than most people do—and using hand sanitizer throughout the day are good flu preventives. Should you get the flu, here’s McBride’s advice: drink lots of liquids, stay in bed, and take cough and pain medicine.

Rich Barlow

Rich Barlow can be reached at barlowr@bu.edu.

9 Comments on Cold or Flu? Don’t Ask for Antibiotics

  • Meowsy on 12.13.2012 at 5:13 am

    I understand not prescribing antibiotics when they are not necessary, but last year Student Health would not prescribe me antibiotics for a sinus infection from Hell that I’d had for weeks and wasn’t going away. It would be more effective if you could also decide when it is necessary to prescribe them. I had to suffer for over a month with my sinus infection until it was apparent that it wasn’t going to get better on its own, and only then could I get antibiotics. I basically had to beg for them. It was ridiculous, affected my schoolwork, and made my semester pretty miserable.

    • A on 12.13.2012 at 10:12 am

      I have to agree, Meowsy. As an undergrad, I was told that Student Health would not prescribe antibiotics until you had been sick for at least 10 days. I got sick 10 days before Thanksgiving, and instead traveled home to see my family doctor- who told me that I was on the brink of pneumonia and should have had antibiotics a week ago, and that BU’s policy was flat-out negligent.

      My husband had a similar incident as a grad student at BU as well: he was sick for 6-8 weeks, went to Student Health three times, and was told that colds normally take 8 weeks to go away, and that he probably was asthmatic. Only on the third visit when both of us went into the exam room and absolutely demanded treatment was he given antibiotics. He started improving almost immediately after the first dose.

      I agree that people shouldn’t be given antibiotics for colds, but that is no reason to deny treatment to someone who actually needs it.

      • Meowsy on 12.13.2012 at 2:51 pm

        That’s what happened to me! I was so bad that I was on my way to getting pneumonia. I even had the bacterial kind of sinus infection, so antibiotics definitely made sense to treat it, but still they denied me. It’s not like I had anywhere else to go. Like I said below, they tell you stuff like to rest, but you get in trouble for missing class. If you ask for an excuse to miss class for illness that says you’ve been to SHS, they won’t give you one. So basically, it’s tough crap if you get sick at BU and don’t live in the area.

        • A on 12.13.2012 at 5:25 pm

          Mass General Hospital has a walk-in clinic and the CVS in Porter Square has a MinuteClinic. If you’re not on Chickering, they might be viable options.

      • David McBride on 12.14.2012 at 12:47 pm

        Great discussion. Just to ground some of the conversation…we at SHS have no “policy” against the use of antibiotics. We recommend thier use when they are clinically appropriate, no matter how long an individual has been ill. There is the misunderstanding that using antibiotics early in a viral infection will “prevent” the progression to a secondary bacterial one…secondary bacterial infection being a relatively uncommon result of viral infections. No one likes to be sick longer when they need to, but an unfortunate reality is that adults experience 2-5 colds per year and children six to ten. College aged people likely lay somewhere in the middle of that. A typical cold lasts a week to two weeks and one’s body solves the problem in that time.

        Our practice represents our ongoing review of the best available medical evidence and active conversations with our colleagues at the School of Medicine (at which several of us are faculty). From this active review, we have a clear position of avoiding contributing to the “vast overprescription” (thanks Dr. Lamorte) of antibiotics that current literature clearly supports.

  • DMR on 12.13.2012 at 9:46 am

    “Tincture of Time” is a tough pill to swallow but a necessary one!

  • SigChi on 12.13.2012 at 12:29 pm

    listen kid, that’s not how it is. “McBride’s advice: drink lots of liquids, stay in bed, and take cough and pain medicine.” for crying out loud we are all adults here. some of us have EXAMS to take and we cant stay in bed. how about some real advice instead

    • Meowsy on 12.13.2012 at 2:46 pm

      They tell you to rest, then you get in trouble for missing class. They won’t give you an excuse either. So, yeah, helpful advice indeed…

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