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I've heard both ways; people going to the doctor for a cold and then getting a prescription for antibiotics and those that go to the doctor and told they have ride it out because it's a viral infection. Do antibiotics really help in true cases of a viral cold?

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I have been told that in some cases patients will refuse to leave without some kind of prescription and rather unethically some doctors go along with it for a quiet life. –  Rory M Sep 26 '12 at 20:07
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No, they don't. I'll return to this question if I have time with a full answer, but the largest reason people receive antibiotics if they have a viral infection is because they expect the doctor to give them antibiotics and will pester the physician about it. Sometimes the "prescriptions" are placebos to simply give the patients something, but physicians are well aware that antibiotics rarely do anything for viral infections. –  MCM Sep 26 '12 at 20:07
    
And a recent german govt report states 50 per cent of AB prescriptions are inadequate. –  rwst Sep 27 '12 at 15:39
    
@MCM Better cite sources for that since I know doctors who do prescribe antibiotics for the reason outlined in Bitwise’s answer. Can’t say I’m a fan of this wasteful use of antibiotics but there you go. –  Konrad Rudolph Sep 30 '12 at 10:56
    
@KonradRudolph - So do I. I didn't say it was the only reason, nor practiced by all Doctors. But the reason I stated was the most common while I volunteered in my local E.D. –  MCM Sep 30 '12 at 13:54
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up vote 8 down vote accepted

In general antibiotics don't help with viruses. However, sometimes a bacterial infection may follow a cold virus, so there might be some scenarios in which antibiotics would be needed. However in many cases it could be due to people demanding antibiotics from their doctor.

You can read more here (CDC site): http://www.cdc.gov/Features/getsmart/

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Doctors should be well aware of viral disease needing antiviral and occasionaly antibiotic(this is not only because of 2nd order infection by bacteria but also some viruses occasionally get killed by the antibiotic without an antiviral or 2nd order bacterial infection)

Also I have heard on medical sites that viral pneumonia is less severe than bacterial pneumonia is. I don't believe that. Most LRT infections are severe whether it is viral or bacterial and there are lots more viruses that can cause pneumonia than there are bacteria that can cause pneumonia. There is also non-infectious pneumonia that can be caused by vomit, water, or food. Why are these non-infectious? Well if some cooked food goes into your lungs infectious disease is very unlikely and if it gets deep enough it can cause inflammation without an infection. Similar things go for filtered water and vomit. I myself have had water going down the wrong pipe and I once had that kind of vitamin pill that you chew on stuck in my trachea and I thought I was chocking but my breathing was normal and after a few days that stuck in my throat feeling went away.

One cause of pneumonia, especially in young children is them having a cold and thus their immune system is weakened and they get viral pneumonia from the flu for example or bacterial pneumonia.

Signs of pneumonia: high BR(breathing rate) fluid in lungs high HR and BP could be caused by the high BR, especially high HR. normal signs of ILI(that is cough, fever, and/or sore throat)

Viruses overall are more deadly because we have a lot more bacteria without infection than we do viruses without infection assuming the immune system is average and so it should follow that viral pneumonia is more severe than bacterial pneumonia.

For Viral Pneumonia: http://www.lung.org/lung-disease/pneumonia/symptoms-diagnosis-and.html This site here tells me something I don't believe about Viral pneumonia. That is that Viral pneumonia is less serious than bacterial pneumonia.

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Why would a viral (excepting an actual immunodeficiency virus) infection make your immune system weaker? If anything, it should more stimulated. –  Superbest May 30 at 7:30
    
well you know how viruses infect cells. Well that is one way of weakening the immune system because what if it infects a B cell or something and is not naturally an immunodeficiency virus? Also when you get 1 infection your immune system is so focused on that 1 infection that all other infections are all of a sudden easier to get a more serious form of. This is in fact why secondary infection is so common. –  caters May 30 at 7:32
    
If you have an HIV infection, you probably should be taking antibiotics anyway. And if it's not an immunodeficiency virus (the question is about a cold) then why would the virus infect B cells? How does the immune system "focus" on one infection? There are many non-specific responses like inflammation, runny nose, fever, interferons, macrophages, etc. Probably the biggest specific response is making antibodies, but making one kind of antibody doesn't prevent you from making a second kind, I think. –  Superbest May 30 at 7:39
    
If it is not naturally an immunodeficiency virus it can infect cells in your immune system just like how something that doesn't naturally infect the lungs could possibly do that if you breathed a high concentration of it. 1 infection makes all other infections more likely and more severe. Because of this is it very easy for a baby to get viral pneumonia and very easy to get secondary infection when you have either tuberculosis or HIV. –  caters May 30 at 12:33
    
Viruses tend to have tropisms towards one cell type or another dependant on receptor expression. TB and HIV both affect cells of the immune system (TB by proliferating inside of macrophages) which is the mechanism behind their secondary infection link. Babies tend to be more vulnerable in the window where they are not protected by maternal IgG but haven't had time to synthesise their own yet. However, there's no real reason for someone on effective HAART to be taking prophylactic antibiotics whilst living with HIV. –  Rory M May 30 at 21:21
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Antibiotics kill bacteria, not virus! So it's just plain wrong. If a bacterial infection appears after the cold, then the antibiotics should be prescribed because of the bacterial infection, not because of the cold. There is a serious concern about misuse of antibiotics promoting hyper-resistant bacteria through natural selection, but doctors keep ignoring alerts from WHO and prescribing antibiotics without even knowing the bacterial strain. It's absurd that a doctor should prescribe an antibiotic just because "the patient needs to get some medicine to be happy". In this case he/she should prescribe a placebo, not a real antibiotic (and there's still the point that killing most bacteria in our body destroy one of our defensive lines against pathogens). Confirming this point, according to American Medical Association, medical error is the third death cause in USA. So in many cases, yes, it might just be a medical error.

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Now for those that think this is not an answer, explain me why? –  Rodrigo May 31 at 1:55
    
"7000 deaths/year from medication errors in hospitals" –  Rodrigo May 31 at 2:01
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You're general sentiment is correct. However, it does not address the reality of how doctors end up prescribing the antibiotics in any case. The main reasons come down to: viral and bacterial infections may look similar in early stages and so it is prophylactic; patients can be "demanding" and get a prescription before leaving the office; and some doctors may use poor judgement. Prescribing a placebo is unethical when the potential for harm can be real (what if a patient is immunocompromised?). Lastly, the 7000 deaths/year is not specific to antibiotics and is an irrelevant statistic to cite. –  leonardo Jun 1 at 2:07
    
WHO alerts about misuse of antibiotics are not irrelevant. If a doctor don't know if an infection is viral or bacterial, how can a medicine be prescripted? And medical error as a "third cause of death" is irrelevant, in your opinion, really? –  Rodrigo Jun 1 at 2:39
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You're missing the point, and clearly you have some agenda to make. I agreed that doctors can mis-prescribe, or even err on the side of caution to prescribe, antibiotics. It takes a long time to assess whether common infections are bacterial or viral because they have to wait for strains to grow or viruses to be immunoassayed. You seem to be taking a lot of "facts" completely out of context. For instance, 7000 deaths/year, where? The USA? So that is 0.002% of the population, or several of orders of magnitude smaller consider the number of hospital visits. –  leonardo Jun 1 at 18:05
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