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Do I REALLY Need an Antibiotic?

written by Linda Anegawa MD, FACP Written by Linda Anegawa MD, FACP
Linda Anegawa MD, FACP

Linda Anegawa MD, FACP

Dr. Anegawa graduated from the Univ. of Pennsylvania School of Medicine and completed residency at Stanford. She has over 20 years of practice experience and specializes in Internal Medicine and Obesity Medicine.

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December 27, 2021 Read Time - 4 minutes

Those old familiar symptoms have struck again – you may have a stuffy, runny nose, green phlegm, bad facial pressure, fatigue. You may have started to cough too. But does this mean you REALLY need antibiotics? Read on to find out.

What is a Sinus Infection?

A Sinus Infection means that the tissues in the sinus cavities of your head are infected or inflamed. In the past, doctors believed antibiotics were necessary to treat the infection. However, through research we now know that the vast majority of sinus infections are caused by viruses and allergens, not bacteria.

What is Bronchitis?

Bronchitis is also known as a Chest Cold. Bronchitis occurs when the airways of the lungs become swollen and begin to produce excess mucus, which is what makes you cough, and is what makes your chest feel tight. Bronchitis is caused by viruses or allergens, similar to Sinusitis. And believe it or not, even when Bronchitis is rarely caused by bacteria, antibiotics aren’t even recommended anymore, as your body can clear these bacteria on their own generally within 3 weeks.

I Have Green or Yellow Mucus. Do I Need Antibiotics?

One of the first signs of a sinus infection or bronchitis is green or yellow mucus. This discoloration is from white blood cells rushing in to battle infection. This discolored mucus will eventually get flushed out of the body along with the virus. The colored mucus comes from dead white blood cells and other debris in the sinus cavities and airways. The mucus can even turn dark brown, too. It’s no reason for concern, and in fact, it means your body is working extra hard to fight off infection.

What are My Treatment Options for Sinusitis or Bronchitis?

Per new guidance from the CDC, antibiotics are not likely to be necessary or helpful – plus, they may harm the ‘good bacteria’ in our gut which plays a critical role in our immunity as well as regulation of body weight. Most symptoms will clear completely in 2-3 weeks entirely on their own.

Recommended measures for Sinusitis or Bronchitis: lots of fluids, decongestants, mucolytic medications such as Mucinex, and nasal saline rinses or sprays, Neti pots, or steroid sprays such as Budesonide or Fluticasone. If over-the-counter drugs are not helping you, prescription medicines such as cough suppressants, steroids, and inhalers are also available from a doctor, such as online at PlushCare.

Oregano oil in a pot of boiling water and breathing in the steam can help with sinus symptoms, too. Oregano is anti-inflammatory and has antiviral and bacterial properties as well.

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What are Other Things I Should Watch For?

COVID-19 symptoms can look exactly like Sinusitis, Bronchitis, colds, and allergies. Your doctor will likely recommend COVID-19 testing. You can still have COVID-19 infection, even if you have already had it before, have been vaccinated and boosted, and even if you don’t have what we think of as ‘typical’ COVID-19 symptoms such as fever and loss of taste and smell.


Read More: Cold vs COVID-19


Symptoms to watch out for and report to your doctor:  illness lasting longer than 3 weeks, new fever > 101.5, or worsening symptoms overall.  If you have an underlying lung condition, are immunocompromised, use inhaled nicotine, or have diabetes, additional prescription medication may be needed, too.  You can book a same day online appointment with a PlushCare doctor, where you’ll be evaluated and treatment options discussed.


Read More About Antibiotics


Medications are prescribed at the sole discretion of a PlushCare physician. Prescriptions for non-controlled substances can only be written after a medical evaluation. Scheduling an appointment does not guarantee that a medication can or will be prescribed.


*NOTE: Due to a lack of scientific data at this time, PlushCare physicians do not prescribe ivermectin, hydroxychloroquine, or azithromycin/other antibiotics to treat COVID-19.


Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

Centers for Disease Control and Prevention. Sinus Infection (Sinusitis). Accessed December 27, 2021 at https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/sinus-infection.html

Centers for Disease Control and Prevention. Chest Cold (Acute Bronchitis). Accessed December 27, 2021 at https://www.cdc.gov/antibiotic-use/bronchitis.html

Centers for Disease Control and Prevention. Treatment for Common Illnesses. Accessed December 27, 2021 at https://www.cdc.gov/antibiotic-use/common-illnesses.html

American College of Physicians. ACP’s Best Practice Advice addresses appropriate use of short course antibiotics in common infections. Accessed December 27, 2021 at https://www.acponline.org/acp-newsroom/acps-best-practice-advice-addresses-appropriate-use-of-short-course-antibiotics-in-common-infections

American Academy of Family Physicians. FamilyDoctor.org. Antibiotics: When They Can and Can’t Help. Accessed December 27, 2021 at https://familydoctor.org/antibiotic-resistance/

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