Is it just a chest cold, do I need antibiotics…or is it COVID?

Even before the explosion of the novel coronavirus, it’s been hard to tell whether or not your symptoms require antibiotics. Congestion, sniffles, a cough that’s keeping me or a loved one up at night. Who knows? As the weather turns colder and we spend more time going inside and out, we often get a chest cold (acute bronchitis) that isn’t typically helped by a prescription for an antibiotic. But when in doubt, get the antibiotic prescription, right?

Not necessarily.

2020 U.S. Antibiotics Awareness WeekAs we mark U.S. Antibiotic Awareness Week 2020 — probably not coincidentally at the start of cold weather and the busy holiday season — it’s important to remember that the overuse of antibiotics could return you, or the population as a whole, back to a time when simple infections were often fatal.

Among its other charters, the Centers for Disease Control and Prevention (CDC) works to improve antibiotic prescribing and use in healthcare, educating patients — the first line of defense — in appropriate antibiotic use. By optimizing how we use and prescribe these drugs, we help protect patients from harm while combating antibiotic resistance.

The CDC has an excellent website specifically geared towards answering questions about antibiotic use, with sections for patients, healthcare professionals, ways to improve outpatient antibiotic prescribing, and more.

28% of antibiotics unnecessary; can lead to side effects, heightened resistance

The Antibiotic Awareness week section has a sobering opening statement and statistic: Though antibiotics can save lives and are critical tools for treating a number of common and more serious infections, like those that can lead to sepsis, the CDC reports that at least 28% of antibiotics prescribed in U.S. outpatient settings are considered unnecessary. Any time antibiotics are used, they can cause side effects and contribute to the development of antibiotic resistance, one of the most urgent threats to the public’s health.

COVID-19 brings extra vigilance…and fear

This is particularly valuable this year, as each of us — as individuals, parents, spouses and others — carefully weigh early symptoms to try our best to determine whether it is just a cold or sinus infection or whether it’s leading to something far more dangerous…up to and including COVID-19.

While we appear to be on the cusp of releasing at least two COVID-19 vaccinations that reports say highly effective, indications are that it could take months for the vaccines to reach all Americans. Front-line healthcare workers, first responders, teachers and those at high risk due to their age and/or pre-existing conditions will be among the first (and pretty much in that order).

So in the meantime, we’ll need to be extra-vigilant in assessing symptoms and balancing the need to be proactive with (A) the risk of leaving our homes for a doctor’s office, walk-in clinic or Emergency Department visit and (B) adding increased volume to the many healthcare providers who are already overloaded working long hours to save lives.

A common-sense guide to treating common illnesses

One of the sections of the CDC website is an easy FAQ highlighting the likely effectiveness of antibiotics for a cold, ear infection, influenza, sinus infection, sore throat, urinary tract infection (UTI) and more. For some, the answer is yes (a UTI, for example); for others, the answer is no…or requires a conversation with your doctor. (If your provider offers a telehealth visit option, that may be a safe and efficient way to start the conversation.)

If symptoms are early indicators of COVID-19 — a virus that can worsen very quickly and potentially be deadly — think through just how cautious you or your children have been in limiting contact with other people, how diligent you’ve been in wearing a mask (over both your nose and your mouth; here’s graphics and short text covering of dos and don’ts for choosing, wearing and washing your masks), and washing your hands thoroughly.

(By the way…A tip shared by nurses in particular over and over: ensure you also wash your thumbs when you’re singing “Happy birthday” twice to reach the 20-second recommended minimum time spent each time you wash your hands. We often forget those little fingers dangling on the end of each hand.)

Note that the CDC’s overview of mask-wearing states that masks should not be worn by children younger than two, people who have trouble breathing, or people who cannot remove the mask without assistance. Otherwise, masks with two or more layers are highly recommended to help stop the spread of COVID-19.

Protecting yourself and your loved ones

Other than what’s stated above and shared by medical experts, here’s a link to an excellent page with easy-to-view icons and short copy as reminders to protect the health of you and your family during this challenging time.

Home for the holidays…?

We’re all tired of being isolated from family and friends, especially as the holidays approach. But a meme I saw on Facebook is apt: Better a digital Thanksgiving than a Christmas (or Hanukkah) in the ICU. As we at RxLive know, thank heavens for the power of digital connections across our team and, most importantly, with our customers.

We can also help your physicians not only to monitor your intake of prescriptions, OTC medications and supplements and foods for potential interactions, but also any concerns about integrating a new antibiotic into your medication regime. New antibiotics are introduced each year, and each can have an adverse reaction to other things you’re taking. Especially for family physicians who are challenged to treat patients for a wide variety of issues, as the American Association of Family Physicians states, recognizing drug interactions is a daily challenge. That’s one of the many reasons why we’re increasingly becoming extended members of their care team.


HOLIDAY UPDATE: As I was writing this today, the CDC has strongly urged Americans not to travel during the Thanksgiving holiday and to consider cancelling plans to spend in-person time with friends and family outside of their household. It’s because of the seven-day surge of average daily new COVID-19 cases, surpassing more than 162,000 per day. It’s not exactly the Norman Rockwell painting we think of, picturing family and friends around the dinner table. But again, this year use the Internet to share the meaning of Thanksgiving with them safely.

Also please note that so our team can celebrate the Thanksgiving holiday weekend (Thursday through Sunday, Nov. 25-29), RxLive will be closed on Thanksgiving and “Black Friday.”

So continue to stay safe, check out some of the links in this blog, and here’s to a safe and happy — if unique — holiday season and, hopefully, a much better 2021!


Protecting Patients and Stopping Outbreaks (CDC website, for healthcare providers)
Protecting Yourself and Your Family (CDC, web page and one-page, downloadable/printable PDF

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.