4 Common Infections That Don’t Require Antibiotics

Rates of antibiotic resistance are rising around the world, largely due to misuse and over-prescribing of antibiotics.  In fact, a whopping 50% of antibiotics given to patients in the U.S. each year are incorrectly prescribed, are for infections that won’t respond to antibiotics, or are misdiagnosed viral infections, such as the common cold.

Because there’s lots of misinformation floating around about antibiotics, we wanted to take time to talk about four common infections that, contrary to popular belief, don’t require antibiotics!  By avoiding unnecessary antibiotics, patients can help protect themselves against antibiotic resistance, and avoid potentially serious antibiotic side effects.


Many patients who develop nasal congestion, sinus pressure, a sinus headache and a runny nose think that if they get a prescription for antibiotics, they’ll feel better faster.  However, up to 98% of sinus infections are viral, which means no amount of antibiotics will help, since antibiotics only kill bacteria and have no effect on viruses.  Most sinus infections will resolve within 7-10 days, and the symptoms will improve with simple home treatments like over-the-counter decongestants and nasal saline rinses. 

It’s only when patients have symptoms more than 10 days, a fever, facial swelling or sudden and severe sinus pain that they meet the criteria for bacterial sinusitis and require antibiotic treatment. 


Acute bronchitis is a respiratory infection which causes chest congestion and a “wet” cough.  Many patients correctly diagnose themselves with bronchitis but incorrectly assume that because they have bronchitis, they need an antibiotic. 

Research has shown that, in fact, 90% of bronchitis infections are caused by viruses, which means antibiotics are not only unnecessary but also may cause dangerous side effects and complications.  

Also, many patients assume that if they’re coughing up yellow or green sputum, they have a bacterial infection.  But the color of sputum does not correlate with whether an infection is viral or bacterial.  Having a fever (temperature > 100.4° F) and/or symptoms lasting more than 10-14 days are more reliable indicators of bacterial bronchitis than the color or production amount of sputum.           

Pediatric Ear Infections

Believe it or not, many cases of otitis media (middle ear infections) in children resolve on their own, even if they’re caused by bacteria.  A research study of 1400 children revealed that  50% of ear pain resolved in 72 hours without antibiotic treatment, and  90% of pediatric ear infections completely resolved without antibiotic treatment in 8-9 days. Mild painkillers that help to ease the pain are about the best you can do.

The American Academy of Pediatrics recommends that antibiotic treatment be reserved for infants, children with significant fevers or children who fail to improve (or worsen) 72 hours or more after the onset of symptoms.

Sore Throats

It’s important for patients who have a sore throat to be evaluated because if they do have strep throat, an antibiotic is required to prevent systemic complications stemming from antibodies to Group A Strep that can damage patients’ hearts and kidneys.

However, 90% of sore throats are caused by known viruses, which means they don’t require antibiotic treatment and will resolve on their own within 7-10 days.  When patients are appropriately diagnosed with viral pharyngitis, they can avoid unnecessary antibiotics and the risk of side effects and antibiotic resistance that come with antibiotic overuse.

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