16386 Antibiotics

Overview

Antibiotics are medicines that kill bacteria or stop them from multiplying. They are used only for infections caused by bacteria, such as some chest infections, urine infections, skin infections and throat infections. Antibiotics do not work on viruses, which cause most colds, coughs, sore throats and flu. Taking antibiotics when you don't need them doesn't help you get better faster, and it can make future infections harder to treat.

Very common. Antibiotics are among the most prescribed medicines worldwide. Many people are given one each year, often for chest, urine, skin, ear or throat infections.

Anyone can need antibiotics at some point, from babies to older adults. Some people are more likely to get bacterial infections or to need antibiotics more often, including people with long-term lung or heart conditions, people with weakened immune systems, people who have recently had surgery, and people who live in close contact settings such as care homes.

Symptoms

Common symptoms

• Fever or feeling hot and shivery
• A cough that brings up thick or coloured phlegm, or chest pain when breathing deeply
• A sore throat with white patches on the tonsils and swollen neck glands
• Burning or stinging when passing urine, needing to go often, or cloudy urine
• Skin that is red, warm, swollen, painful or leaking pus
• Ear pain or fluid coming from the ear
• Feeling generally unwell, tired or off your food for more than a few days

Symptoms in children

• High temperature, or a temperature that keeps coming back
• Pulling or rubbing at an ear, or being upset when lying down
• Poor feeding or drinking less than usual
• Being unusually sleepy, floppy or hard to wake
• Fewer wet nappies than usual
• A sore throat that makes swallowing difficult, or drooling

Symptoms in older adults

• New confusion or unusual drowsiness, which can be the main sign of infection
• A fall or sudden loss of mobility
• A temperature that is low rather than high
• Weakness, dizziness or generally feeling 'not themselves'
• A cough, urine changes or skin redness that may be less obvious than in younger people

Causes

Main causes

• Bacterial infections, such as some chest, urine, skin, ear or throat infections, which are the only reason antibiotics are prescribed
• Viral infections, such as colds and flu, which do not respond to antibiotics — this is why they are often not needed
• Bacteria becoming resistant to antibiotics after repeated or unnecessary use, so the same medicine stops working

Risk factors

• Having a long-term condition such as asthma, COPD, diabetes or heart disease
• A weakened immune system, for example from some medical treatments or illnesses
• Recent surgery, a wound, or a medical device such as a urinary catheter or drip
• Being very young or elderly
• Living in a care home or other shared setting where infections spread easily
• Having taken antibiotics often in the past, which raises the chance of resistant bacteria
• Not following the instructions given with your prescription, or saving antibiotics for later use

When to see a doctor

See a doctor urgently if:

• You or someone you care for has any of the emergency signs listed above — call your local emergency number straight away
• A fever with a stiff neck, severe headache or a rash that does not fade under pressure
• Symptoms that are quickly getting worse, or you feel very unwell
• A baby under 3 months old with a temperature of 38°C or higher, or any baby who seems very unwell
• You cannot keep fluids down, or you are passing much less urine than usual

Book a routine appointment if:

• Symptoms have lasted more than a few days without improving
• You think you may need antibiotics, or you want to talk about whether they would help
• You have had several infections close together
• You have side effects from antibiotics, such as a rash, severe diarrhoea or feeling sick
• You are unsure whether to finish a course or how to take your medicine

Diagnosis

A doctor, nurse or pharmacist will ask about your symptoms, how long you have had them, and any other health conditions. They will examine you — for example listening to your chest, looking in your ears and throat, or checking your skin. Using this information, they decide whether your infection is likely to be viral or bacterial. Many infections can be safely diagnosed from your story and an examination alone, without any tests.

Tests that may be done

• A throat swab or saliva sample to check for specific bacteria
• A urine sample to look for infection in the bladder or kidneys
• A blood test to check for signs of infection or to see how your body is coping
• A sample of phlegm, or a swab from a wound or skin sore
• A chest X-ray or scan if a deeper infection is suspected
• In some cases, a test to see which antibiotic is most likely to work

What to expect at your appointment

You may be told that antibiotics are not needed and given advice on managing symptoms instead. Sometimes your clinician will suggest waiting a couple of days to see how things go, or will give you a prescription to use only if you are not improving. This is a normal and safe approach, and you can always come back if you are worried.

Treatment

Treatment depends on what is causing your infection. If it is viral, antibiotics will not help and the focus is on easing symptoms and letting your body recover. If a bacterial infection is likely, your clinician will choose an antibiotic that suits the type of infection, your age, your other health conditions and any allergies. The aim is always the right antibiotic, at the right dose, for the right length of time.

Self-care at home

• Rest as much as your body tells you to, and go back to normal activity gradually
• Drink plenty of fluids — water is best; warm drinks can soothe a sore throat
• Ask your pharmacist about over-the-counter options to ease pain or fever, and check they are safe for you
• Keep warm, and use a humid room or steam to help a blocked nose or cough
• Wash your hands often to avoid passing infection to others, and stay home while you feel unwell
• Write down when you take your medicine, or set a reminder, so doses are not missed

Medical treatments

When antibiotics are needed, your prescriber will explain how and when to take them, and for how long. Take them exactly as described, and ask your pharmacist if anything is unclear. Some antibiotics work best on an empty stomach and others with food, so check the label. Do not save leftover antibiotics for next time, do not share them with anyone else, and ask your pharmacist how to safely return any you do not use. If you get side effects such as a rash, severe or persistent diarrhoea, or feeling very sick, contact your doctor or pharmacist promptly. Antibiotics can sometimes cause thrush or loose stools, and your pharmacist can advise on managing this. If you have been prescribed antibiotics and are not improving within the time you were told to expect, let your clinician know rather than stopping on your own.

When is surgery considered?

Surgery is not used to treat most infections, but it can help in specific situations — for example draining a build-up of pus (an abscess), removing an infected tooth, or treating an infection inside the body such as appendicitis. Antibiotics are often given alongside or after these procedures to help clear the infection.

Living with this condition

Most people recover well from an infection within one to two weeks. While you recover, keep things gentle: short walks, plenty of sleep and a bit of patience with yourself. If you are taking antibiotics, keep to the schedule and finish the course as your prescriber explained. Note any changes in your symptoms so you can describe them clearly if you need to check back in.

Lifestyle tips

• Wash hands regularly with soap and water, especially before eating and after using the toilet
• Cover coughs and sneezes, and use tissues you throw away
• Keep up to date with recommended vaccinations
• Avoid sharing towels, cups, cutlery or toothbrushes during an infection
• Only take antibiotics prescribed to you, and never pressure a clinician for one when it is not needed
• Return unused antibiotics to a pharmacy rather than keeping them at home

Diet and exercise

There is no special diet that treats a bacterial infection, but eating regularly and drinking enough fluids supports recovery. If your appetite is low, try smaller meals more often and sip fluids throughout the day. Gentle movement such as walking around the house is fine once you feel able, but avoid intense exercise while you have a fever or feel very tired. Build activity back up slowly over a week or two after you start feeling better.

Mental health and emotional wellbeing

Being unwell can affect your mood — you may feel low, anxious or frustrated, especially if symptoms drag on or you are worried about needing antibiotics. This is common and usually lifts as you recover. If you feel persistently low or anxious, or you are having thoughts of harming yourself, please reach out for help right away. In the UK you can contact NHS 111 or your GP; Samaritans are available on 116 123. Elsewhere, contact your local emergency number or a crisis line in your country.

Prevention

You cannot prevent every infection, but you can lower the chances of getting one and help keep antibiotics working for everyone. Good hand hygiene, keeping recommended vaccinations up to date, preparing food safely and avoiding close contact with people who are unwell all help. Just as important is using antibiotics wisely: only when prescribed, exactly as directed, and never saved or shared.

Vaccines

Staying up to date with routine vaccinations — including those offered for flu, pneumonia and other infections depending on your age and health — reduces the chance of infections that can lead to bacterial complications. Ask your GP or pharmacist which vaccines are recommended for you.

Complications

If left untreated

• A bacterial infection can spread — for example from the bladder to the kidneys, or from the skin into deeper tissue
• Some infections can become serious, causing very low blood pressure and damage to organs (sepsis), which needs emergency care
• A build-up of pus (an abscess) may need draining
• Antibiotic side effects, such as loose stools or thrush, can be uncomfortable
• Using antibiotics when they are not needed encourages resistant bacteria, making future infections harder to treat for you and for others

Long-term outlook

The great majority of people recover fully from common infections, with or without antibiotics. When antibiotics are truly needed, they are usually very effective. By using them wisely — taking them only when prescribed and exactly as directed — you protect your own future health and help keep these important medicines working for everyone.

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