Sometimes people need antibiotics for flu, but not to treat the initial virus that creates flu symptoms. In the first few days of flu, people tend to feel awful, may have a high fever, and probably experience sore throat, nasal congestion, cough and extreme tiredness. As bad as these initial symptoms may seem, antibiotics for flu is typically not warranted because the symptoms are viral in origin, and an antibiotic does not influence the course of viruses. Gradually, over about two weeks, most people will recover, and any antibiotic treatment would not have improved recovery.
The statement that antibiotics for flu are not necessary is made with the proviso that they are not necessary if a person doesn’t develop a secondary bacterial infection. Antibiotics can become vital if people develop complications of the flu like sinus infections, bronchitis, ear infections or pneumonia. Many healthy people never develop these infections. The medically vulnerable due to chronic disease, very young or old age, or exceptionally poor living circumstances are at greater risk for infection. A person with cystic fibrosis or someone living in a nursing home might even be prophylactically treated with antibiotics at the onset of flu in order to prevent serious secondary infection.
For most people who are healthy, doctors won’t use antibiotics for flu, unless there are evident signs of a bacterial colonization. Patients often want to know what signs to look for that might indicate bacteria. One of the principal signs may be that people begin to feel better and then experience what seems like a relapse.
During this relapse, weakness may increase, nasal congestion, which may be green or bloody, could get worse, cough might be more pronounced and feature tight chest or chest pain, high fever could return, or people could feel pronounced pressure around the sinuses, headache, or significant ear pain. Another scenario that can suggest antibiotics for flu are necessary is when people don’t recover sufficiently within the expected time period. Usually if flu symptoms, aside from a residual cough, last more than 14 days, they are evaluated as potentially bacterial in nature.
It bothers some patients that antibiotics for flu are not routine because, in the past, many doctors prescribed them, even if a bacterial infection wasn’t present. The known creation of drug resistant bacteria through antibiotic overuse translates to greater physician caution when prescribing antibiotics now, unless they really seem warranted. There are medications that help reduce length of the flu, including Tamiflu®, but this drug needs to be taken early in the flu’s course, and can have unpleasant side effects. Other medications that may help treat symptoms of flu include fever reducers, decongestants, and cough syrups. Doctors often encourage home remedies like chicken soup and plenty of rest and fluids, but patients are urged to consult their doctors if they are worried about their state of health or feel they have evidence of a bacterial illness.