5 things you need to know about antibiotics this flu season

When Joseph developed a persistent cough, he booked a visit with his longtime family physician. The doctor diagnosed bronchitis and recommended rest and plenty of fluids. “What about antibiotics?” Joseph asked. “The flu is going around my office, and I have deadlines to meet.” The doctor hesitated. Then he saw how anxious Joseph was and agreed to call in a prescription.

What’s wrong with this picture? Joseph and his doctor are unknowingly contributing to the rise of “superbugs,” or drug-resistant germs. Treating a cough with an occasional Tylenol or Advil won’t do any harm, even if the medication doesn’t relieve your symptoms. But antibiotics are different, as overuse and misuse can harm you ― and the people you love ― in the long term.

Read on to learn which flu treatments are most effective, how to avoid unnecessary antibiotics, and ways you can help fight the rise of dangerous superbugs.

Will antibiotics help the flu?

Antibiotics have no effect on the flu. The drugs won’t relieve your symptoms, reduce the length of your illness or boost your immunity to other germs. Sure, you may feel better after taking antibiotics, for a simple reason: You were already on the road to recovery. We all tend to seek treatment when our symptoms are at their peak. Over the next few days, as the virus runs its course, you start to feel better. But that would have happened even without medication.

Sometimes, antibiotics can actually make you feel worse. “Antibiotics are generally quite safe, but they do carry some risk,” says Daniel Knecht, MD, MBA, VP of clinical strategy and policy for Aetna. “They may cause diarrhea, allergic reactions and various other side effects.” It’s something to keep in mind if you’re tempted to take unnecessary antibiotics “just in case.”

How to treat flu symptoms

The best medicine for the flu depends on the timing. Besides the usual over-the-counter cold-and-flu formulas, doctors recommends the following:

• The flu shot. You probably know that the flu vaccine helps you avoid developing the flu. But the vaccine also reduces the strength of the virus if you do catch it. (You might even mistake it for a mild cold.) The catch: You have to get your shot before you come down with the flu ― ideally at least a few weeks prior, so your body has time to build up defenses against the virus.
• Drink lots of fluids. Staying extra hydrated can make you feel more comfortable and speed your recovery. Treat yourself to a favorite beverage that will encourage you to keep drinking: juice, electrolyte water, chicken soup or herbal tea with honey and lemon.
• Home remedies. For stomach upset, some people swear by ginger root; natural ginger ale or ginger tea are two good sources. To relieve cough and nasal congestion, the fumes of a menthol ointment, like Vicks VapoRub, or eucalyptus oil (sniff from the bottle or add a few drops to hot water) can help you breathe easier. Inhaling steam is another way to soothe airways; use a humidifier or sit in the bathroom while you run a very hot shower. And you can break up mucus in your nose and throat by gargling with salt water or using a neti pot.
• Tamiflu. Recommended only for high-risk individuals, like seniors and people with chronic medical conditions. Ask a doctor or pharmacist about prescription flu treatment. Tamiflu is an antiviral drug taken by mouth that prevents the virus from multiplying in your body. It decreases your symptoms and the length of time you’re sick. You must take Tamiflu at the first sign of symptoms. If you wait too long, the drug won’t work.

When you need antibiotics ― and when to avoid them

Viruses and bacteria are two types of germs that can cause infection and disease. Antibiotics kill bacteria, but have no effect on viruses. Some illnesses always require antibiotic treatment: strep throat, staph-based skin infections and common sexually transmitted diseases like chlamydia.

Other conditions may be caused by either bacteria or viruses, and it can be hard to tell the difference. If you develop pneumonia, pink-eye or a urinary tract infection, for instance, your doctor may test for bacteria before recommending antibiotics. 

Will antibiotics help?

Always	Sometimes	Never
Strep throat	UTI	Cold
Tuberculosis	Pink-eye	Flu
Chlamydia	Sinus infection	Bronchitis
E. coli	Pneumonia	Yeast infection
Staph infection	Ear-ache	Herpes

Most illnesses that send people to their doctor are caused by viruses or allergies. That means antibiotics won’t help. Typically, you just have to let a virus run its course. Yet 30% to 50% of antibiotics are prescribed for viral illnesses, like bronchitis. “It’s very validating and comforting for patients to receive an antibiotic prescription when they’re not feeling well,” Dr. Knecht explains. “And doctors want to help.” But such overuse is a major contributor to antibiotic resistance.

What is antibiotic resistance?

Antibiotic resistance refers to the ability of some germs to survive the drugs we take to kill them. This can happen as a result of overuse, described above, or misuse, as when a patient with strep throat misses doses of their antibiotics or stops taking their pills once they feel better. Instead of being killed, the strep bacteria are, in the words of one scientist, “educated” in how to fight the drug. Then, if those germs are passed to someone else, the same antibiotic will be less effective.

“Superbugs” are germs that are resistant to many antibiotics. The best-known superbug is MRSA (pronounced MER-suh), a drug-resistant form of staph. Other superbugs cause hard-to-treat forms of pneumonia, tuberculosis, gonorrhea and UTIs. Every year, 2 million Americans fall ill with antibiotic-resistant infections.

Superbugs take more time and money to treat. Today, a simple sore throat or UTI might inconvenience you for a week, until your inexpensive generic antibiotics kick in. In the future, that week could turn into a month ― and multiple rounds of pricey specialized antibiotics.

That’s not all. “Antibiotics are the unsung hero that support many medical breakthroughs,” Dr. Knecht says. “There’s a whole slew of technologies we wouldn’t be able to use if antibiotics stopped working: surgery, dialysis, chemotherapy, gene therapy, bone marrow transplants.” All of these treatments would be too dangerous without effective ways to head off and treat infection.

How you can help fight superbugs

The good news is that we’re making progress in the battle against superbugs. Aetna is working to educate doctors about the dangers of overprescribing antibiotics for common complaints like acute bronchitis, in collaboration with the Centers for Disease Control and Prevention (CDC) and state Departments of Health. In 2018, the program reduced unnecessary prescriptions by 16%. In 2019, the initiative will be expanding to additional states.

But we need your help. You can fight the rise of antibiotic-resistant superbugs by asking the right questions and taking your medication as directed. If your doctor offers to prescribe you antibiotics, ask if they’re really necessary. “Doctors may think people are coming to them for antibiotics,” Dr. Knecht says. “Asking doctors if antibiotics are needed lets them know that you’re there for the right treatment, whatever that is.” And if you do need antibiotics for a bacterial illness, don’t skip doses and do take all the pills prescribed to you, even after you feel better. And don’t share antibiotics with others.

“Imagine a world where you don’t know if antibiotics will work,” Dr. Knecht urges. “Many people don’t recognize how important they are. We need to elevate their status and preserve this precious resource.”