By Dr. Juleen Qandah
Every cold season in the Mohawk Valley, I hear some version of: “I’ve been sick for three days. Can’t I just get an antibiotic?” I understand the wish. You feel awful, the kids are home sick, work is piling up, and you want something that makes this end. But antibiotics are powerful medicines with a very specific job: they treat certain infections caused by bacteria. They do not treat viruses—the cause of most colds, flu, and many coughs.
Here’s a fact that surprises people: more than 200 different viruses can cause the common cold. And when your clear mucus turns yellow or green, that color alone does not mean bacteria have taken over. It can happen during an ordinary cold as your immune system responds. Green mucus is not a tiny bacterial flag.
Antibiotics are the wrong tool for a viral cold. They won’t make it go away faster, prevent someone else from catching it, or stop a cold from turning into a bacterial infection. Taking one “just in case” adds risk without treating the virus.
And antibiotics are not harmless. They can cause nausea, diarrhea, rashes, yeast infections, and, rarely, severe allergic reactions. They can also disrupt helpful bacteria in the gut. One bacteria that can take advantage of that disruption is C. diff, which can cause severe diarrhea and colon inflammation. CDC estimates it causes nearly half a million infections in the United States each year.
There’s another common misunderstanding about antibiotic resistance: your body doesn’t become resistant—the bacteria do. When antibiotics are used unnecessarily, resistant bacteria can survive and spread. That makes some infections harder to treat for everyone.
So when are antibiotics useful? They can be lifesaving for certain bacterial infections, including strep throat, urinary tract infections, and some cases of pneumonia. Even some bacterial ear and sinus infections may improve without them, so a clinician may recommend watchful waiting. That is an active plan: give the body time, manage symptoms, and know when to follow up—not ignore the problem.
For a cold, the best treatment is usually supportive care: rest, fluids, and age-appropriate relief for symptoms. A cough or congestion can linger even after the virus is on its way out. If symptoms are severe, breathing becomes difficult, you’re getting worse instead of better, or you’re worried about a child, an older adult, or someone with a serious health condition, seek medical advice. Some viral illnesses, including flu and COVID-19, may have antiviral treatments for people who qualify; those are different from antibiotics.
During U.S. Antibiotic Awareness Week, November 18–24, ask a better question than “Can I have an antibiotic?” Try: “What do you think is causing this, what can help me feel better, and what changes should make me come back?”
Sometimes the best prescription is an antibiotic. Sometimes it’s time, fluids, and a clear plan. Knowing the difference helps protect your health—and keeps these important medicines working when we truly need them.
Three-question sidebar as a practical visual.
BEFORE YOU ASK FOR AN ANTIBIOTICS, ASK:
What do you think is causing this?
What can help me feel better now?
What changes mean I should call or come back?
