The Prescription You Shouldn't Fill

Want to shock your doc out of his socks? Next time you get a sore throat -- or your kid's nose is at flood stage -- don't demand antibiotics. Half of the 125 million antibiotic prescriptions written for upper respiratory infections each year in the United States and Canada cause more problems than they cure. Antibiotics are designed to knock out bacteria but are 100% useless against viral infections like colds, flu, and many ear infections, sinusitis, and bronchitis.

Unnecessary antibiotics aren't just ineffective. They're bad news. They empty your wallet (at up to $100 per prescription, that's not chump change). They put you at risk for side effects like diarrhea and allergic reactions. AND they contribute to the global rise of antibiotic-resistant bugs. Yet many of us continue to nag for them when we get sick -- and our doctors give in.

In a recent, eye-opening (or sleep inducing -- depends on whether you're a science nerd) Vanderbilt University School of Medicine study, researchers found that while overall antibiotic use for respiratory infections has dropped 36% in the past decade (good), prescriptions for stronger, more expensive broad-spectrum antibiotics increased (bad).

Don't get us wrong. Some viral infections do morph into bacterial free-for-alls. If you or your child develops strep throat, a bacterial ear infection, or pneumonia after a bout of flu, these wonder drugs are essential. But it makes sense to do all you can to prevent a viral respiratory infection in the first place.

That's what they did in Ontario, Canada. The province offered everybody free flu shots starting in 2000. As a result, residents not only received 64% fewer antibiotic prescriptions than other Canadians but also were healthier -- with 52% fewer flu-related hospitalizations and 39% fewer flu-related deaths.

You can do even more. To fight viral infections head-on, start by washing your hands thoroughly and often during cold and flu season; this removes 99.9% of viral particles. Then, take these steps:

Supplement your defenses. Get your vitamin D (1,000 international units a day; 1,200 if you're over age 60), a daily probiotic (a spore form that provides 2 billion units), ginseng (the equivalent of 1 to 2 grams of dried roots), and adequate sleep.

Get both flu vaccines. Seasonal influenza and the H1N1 swine flu are different viral infections, so get protected against both if you are under age 50. Get only the seasonal vaccine if you are over age 50 and free of chronic disease.

Ask about the pneumococcal vaccine. About one-third of deaths attributed to H1N1 have been in people who've also had bacterial pneumonia. The pneumonia vaccines (one is approved for young children, another for people over age 65 and those with health conditions) can lower that risk, but many people eligible for this shot don't get it.

Prevent complications. If your colds tend to become sinus infections, use saline nasal rinses (try a neti pot or clean bulb syringe) to help prevent viruses from breeding in pools of trapped mucus. Rinses help without the side effects that decongestants can cause.

Sore throat? Ask for a rapid strep test. You need antibiotics only if it's strep. Your doc can't tell by looking, so ask for an in-office strep test; these cut antibiotic prescription by two-thirds in one study.

Get help fast for flu complications. Get urgent medical help for a child with the flu who is breathing rapidly or having trouble breathing, has bluish skin, isn't drinking enough fluids, isn't waking up or interacting with others, or is so irritable she doesn't want to be held. Also get help quickly if flu symptoms improve and then return with a fever and a worse cough or if your child has a fever with a rash.

For adults, seek immediate help for breathing difficulty or shortness of breath; pain or pressure in the chest or abdomen; or sudden dizziness, confusion, or severe or persistent vomiting.

Ear infection? Ask for a prescription "to go." Watchful waiting -- with just pain relievers and plenty of cuddling -- clears up at least half of nonsevere ear infections in kids over age 2. Try it for 48 to 72 hours, but have an antibiotic prescription handy, just in case. Tell your doctor you're interested in doing this; in one Harvard study, 60% of parents were willing to give it a try, but just 6% of doctors suggested it regularly.