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Don’t ask doctors for antibiotics for the common cold

Original: eternity4719 · source details

Original author: eternity4719 · Chinese source: · English adaptation: parveen0029. Translation and grade notes ↗

Bibliographic titles are retained in their original language.

Source author's views and grades; not individually verified by this site.

Cost and benefit at a glance
Check the cost Cost ↓
It costs nothing and can even save you money on medicine.
Then the source benefit Benefit ↓
A Cochrane systematic review pooled data from 6 randomized trials involving 1,147 participants. When comparing antibiotic use to placebo for treating colds, there was no significan…

In plain terms

Taking antibiotics for a cold doesn’t speed up recovery compared to not taking them at all. For adults, the risk of side effects is more than twice as high when using antibiotics. For cases where nasal discharge with pus lasts less than 10 days, there is no clear benefit to taking antibiotics either.

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Chapter 34 editorial cartoon: Medicine boxes aren't mystery boxes. Enlarge illustration
Medicine boxes aren't mystery boxes.

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Editorial cartoon · Chapter 34Medicine boxes aren't mystery boxes.

Original illustration with Chinese lettering; the English dialogue is below. Humour is a reading aid, not evidence.

English dialogue
  • They look much the same?
  • What are the ingredients?

Cost: what it takes

It costs nothing and can even save you money on medicine.

Benefit: what the source reports

A Cochrane systematic review pooled data from 6 randomized trials involving 1,147 participants. When comparing antibiotic use to placebo for treating colds, there was no significant difference in the proportion of people who did not recover or whose symptoms persisted (RR 0.83, 95% CI 0.60–1.14, no statistically significant difference). The risk of adverse reactions was 1.8 times higher than in the placebo group (95% CI 1.01–3.21). For adults specifically, this risk was 2.62 times higher (1.32–5.18), while no increase was observed in children (RR 0.91, 0.51–1.63). For acute purulent rhinitis where nasal discharge with pus lasts less than 10 days, antibiotics also showed no clear benefit (RR 0.73, 0.47–1.13). However, the risk of adverse reactions rose by roughly 46% (RR 1.46, 1.10–1.94). The authors concluded that routine use of antibiotics is not recommended for either of these conditions.

Conditions, limits and disagreements

This updated version was released in 2025; the abstract states that literature searches were conducted up to 2013. Antibiotics are prescription-only drugs in China, so pharmacies must sell them only with a valid prescription. Do not take leftover antibiotics at home without medical advice. The “moderate” rating for benefits is based on the fact that antibiotics primarily reduce the risk of adverse reactions rather than preventing death.

Original references

Original bibliographic titles and links are preserved; some titles are in Chinese.

Kenealy T, Arroll B (2025). Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews, 11:CD000247. https://doi.org/10.1002/14651858.CD000247.pub4

Medical, legal, financial and policy conditions vary by person, place and time. Policy material primarily concerns mainland China; check the cited document and current local requirements.