Got a cold? Doctor may prescribe gargling

[Guest guest]

Got a cold? Doctor may prescribe gargling

NEW YORK, Mar 19 (Reuters Health) - Although some people may demand antibiotics

at the first sign of a sniffle, a physician's group says most upper-respiratory

infections do not require antibiotics and are better treated with

over-the-counter cold remedies and old-fashioned salt water gargles.

Antibiotics are effective only against bacteria, and since a majority of cases

of acute bronchitis, sinus infection, sore throat and general upper-respiratory

infection are caused by viruses, antibiotics will not wipe away most patients'

misery. In fact, antibiotic treatment of colds, bronchitis and other

upper-respiratory infections is " almost always inappropriate, " according to the

American College of Physicians-American Society of Internal Medicine (ACP-ASIM).

Inappropriate use of antibiotics is a major reason that certain bacterial

infections have become resistant to the drugs that once kept them in check. The

more an antibiotic is used, the more often bacteria are exposed to it, which

helps the germs mutate into forms that resist treatment. According to the

ACP-ASIM, up to 75% of antibiotic prescriptions each year in the US are for

acute respiratory infections.

To stem the tide of treatment-resistant bacteria that has risen over the past

decade, the organization has issued guidelines on antibiotic use in the March

20th issue of the ls of Internal Medicine.

Although certain upper-respiratory infections such as strep throat and some

sinus infections may require antibiotics, the majority do not, according to the

guidelines. Strep bacteria cause about 10% of sore throat cases in adults, and

sinusitis is sometimes caused by bacteria.

According to the ACP-ASIM, doctors may indiscriminately use antibiotics because

they believe they will help a small percentage of patients or because they want

to prevent the complications of an undiagnosed bacterial infection.

However, the ACP-ASIM notes, these benefits are theoretical, while the

" potential harm of this practice is well established at the level of the patient

and society. "

The guidelines are based on data from the Centers for Disease Control and

Prevention in Atlanta, Georgia.

SOURCE: ls of Internal Medicine 2001;134:479-486.