Viral or Bacterial Illness?

Upper respiratory ailments, sinus and ear infections. These are all very common reasons to visit your health care provider. So, how do you know when an antibiotic is really an appropriate treatment?

Viruses are often the culprit for flu and colds, or runny noses, even when the mucus is thick and green or yellow. Antibiotics will not work on viral infections and even some bacterial infections causing sinus infection, ear infections, or bronchitis will not respond to antibiotics.

Viral and bacterial infection are nearly indistinguishable at first. In general, an illness lasting longer than 10-14 days without noticeable improvement has higher possibility of being bacterial rather than viral or leading to more serious illness.

The following illnesses are almost always viral:

  • Common colds, even with a runny nose that is green or yellow
  • Acute bronchitis (chest cold)
  • Influenza (flu)
  • Many ear infections
  • Sinus infection
  • Sore Throat (except Strep)

When symptoms of these illnesses appear, supportive care is always the best first course of action:

  • Drink, drink, drink. Warm herbal teas, broth, water, popsicles, Jell-O.
  • Avoid milk products as these tend to worsen mucus production.
  • Rest. Take 1 or 2 days to lay low, napping frequently.
  • Take OTC Mucinex to help get mucus up, Tylenol/Advil for fever, body aches, and headache.
  • Apply warm, dry heat to ear(s) for 10 minutes several times daily to lesson ear pain.
  • Neti-Pot nasal rinse may be used twice daily to clear sinuses. Alternatively, non-medicated saline nasal mist may be used several times daily.
  • May use Afrin or Sinex nasal spray as directed on package, but for no longer that 3 days in a row.
  • Use cough drops to ease cough/sore throat.

It may take up to 3 weeks to feel completely “back to normal” but following the above care guidelines, you should feel gradual improvement.

When to seek treatment

Ear Infection

  • Fever greater than 102.2°F  that does not respond to Tylenol or Advil
  • Pus, discharge, or fluid coming from the ear
  • Worsening symptoms or symptoms that last longer than 2-3 days

Chest Cold (Acute Bronchitis)

  • Bloody mucus when coughing
  • Shortness of breath
  • Symptoms longer than 3 weeks
  • Several bouts of bronchitis within 1 year

Common Cold (sneezing, stuffy or runny nose)

  • Difficulty breathing or fast breathing
  • Not Urinating
  • Fever lasting longer than 4 days
  • Symptoms lasting more than 10 days with no improvement.
  • Fever or cough that improve but then return or worsen

Flu (influenza)

  • Shortness of breath or difficulty breathing
  • Persistent chest or abdominal pain or pressure
  • Not urinating
  • Severe muscle pain
  • Significant unsteadiness or weakness
  • Symptoms improve then return

Sinus infection (sinusitis) 

  • Severe headache, facial pain or pain in top teeth.
  • Symptoms lasting more than 10 days without improvement.
  • Fever longer than 3-4 days.

Sore throat (Possible Strep) 

  • Pain with swallowing
  • Fever
  • Swollen tonsils that are red and may have with patches or streaks of puss.
  • Spots on the roof of the mouth