Common colds: Is it better to take antibiotics or not?

It does not make sense to use antibiotics for simple colds. These drugs have no proven benefit, and can have adverse effects.

The common cold is usually caused by viruses. Because antibiotics only work against bacteria, and not viruses, you can usually expect no benefit from these medications for a cold. Sometimes when someone has a cold, a bacterial infection also sets in. In that case, taking antibiotics beforehand would have a benefit if they were able prevent that infection.

To try to be clearer about the advantages and disadvantages of treating colds with antibiotics, researchers from the Cochrane Collaboration – an international research network – specifically looked for trials that not only included the benefits, but also adverse effects of antibiotics. They found 11 trials altogether, which generally included otherwise healthy adults and children.

Antibiotics cannot end a cold more quickly

The researchers found that antibiotics have no proven benefit in simple colds. Participants who took antibiotics had a cold that lasted about as long as it did for the participants who took dummy tablets (placebo). This means that it is particularly important to consider the adverse effects. It can be concluded from the trials that, on average, between 8 and 9 out of every 100 people who took antibiotics had an adverse effect. These were usually diarrhea or other gastrointestinal symptoms like nausea. Other common adverse effects of antibiotics are skin rashes and vaginal thrush.

There were, however, two groups of people who could benefit from antibiotics for the cold. The first are people whose colds have been going on for more than one week. The second group are people with greenish-yellow nasal mucus, a sign that they also have a bacterial infection.

With almost as many people getting adverse effects as experiencing a benefit, these findings do not support the widespread use of antibiotics for common colds. Many experts argue that antibiotics should only be used when they have clear benefits anyway. They are concerned that overuse in minor illnesses could make bacteria resistant so that antibiotics will no longer be as effective when used for treating serious conditions. You can read about the safe use of antibiotics here.

You can read more about the common cold, as well as its prevention and treatment, here.


Author: Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care)