Common Cold

Antibiotics for colds is the never ending discussion.

You may be surprised by how many patients come to ERs with colds, convinced they need antibiotics. Truth is, I can’t blame them. Schools don’t routinely teach kids that antibiotics are used against bacteria, nor that the newer “antiviral” drugs like acyclovir or valacyclovir don’t help with colds, nor that colds are caused by viruses. (I’m pretty sure it took me into my 20s to learn these gems.)

So today nearly every shift I deliver the disappointing news that I don’t have a quick fix… as I pray not to receive the present. I anxiously wait a day when we have an antiviral that actually works for colds. Whoever invents that magic bullet gets a Nobel Prize. However, for now we’re stuck with OTCs, along with red flags and happy words.

Red Flags:

• Difficulty breathing (that doesn’t equal persistent cough)
• Frail
• Elderly
• Diabetic
• Smoker
• Asthmatic
• Neonatal
• Immunocompromised (chronic steroids, chemo, lung cancer)

Happy Words

• Drinking, eating, breathing, peeing, pooping properly
• Relief with ibuprofen or acetaminophen
• Relatives with the same all survived and recovered
• “No matter how much I surf I just can’t shake this thing.”

Until that bullet arrives, it’s chicken soup, tea, honey, ibuprofen with food, rest and lozenges (yellow label Ricola is my favorite). Also be aware that colds are typically worse at night and in the morning. So before racing to the ER, try a warm shower, yogurt, banana, tea, and maybe a little oatmeal. One good friend is a strong advocate for the attached… but I’m a little uneasy with “horehound.”

Lastly, green/yellow sputum does not = bacterial. Please don’t bring your tissues for me to analyze. That’s just gross. “Neti pots” if you’re feeling courageous.

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