Medical authorities are very concerned, about bacterial resistance to antibiotics, due to overuse, and misuse. The majority of upper respiratory infections are caused by viruses, to which antibiotics do nothing. Emerging bacterial resistance to commonly used antibiotics, render these antibiotics useless, in the face of a real infection. Both the public and the physicians are at fault. The problem is worse in Europe, where antibiotics are often sold over the counter.  Nevertheless, the problem is worrisome, and requires educating both physicians and the public against the potential hazards of antibiotic resistance.

            Fever and purulent ( yellow,green ) phlegm or mucous are no longer considered a sure sign of bacterial infection. A sore throat of less than 48 hours is better tested with a 16 hour culture, while a longer duration sore throat can be reliably tested with an in office 5 minute test. The majority of coughs are viral. I have found that the word "Bronchitis", strikes unwarranted fear in patients. In general, a cough that lasts longer than a week should be evaluated by a doctor. The exceptions are diabetics, smokers, and
asthmatics, because these patients have impaired immunity, making them susceptible to secondary bacterial infections, following a viral bronchitis. Only rarely, does bronchitis lead to a pneumonia. Blood in sputum should be evaluated immediately. Sinusitis and ear infections are different in that a good proportion of them are bacterial, and they cause considerable pain and suffering. So, antibiotics are frequently warranted in acute sinusitis, and ear infections. Again, purulent nasal discharge, doesn't mean acute sinusitis. Pressure behind the cheecks, around the eyes, or frontal headache, fever, constant post nasal drip, along with purulent, or bloody nasal discharge, strongly suggest sinusitis.  Bad smelling sputum, doesn't mean infection. Ear Pain should be evaluated by a physician. Again, diabetics, smokers and
asthmatics, should generally have their colds evaluated sooner than the general public, because of theirsuceptibility to infection. Read the newsletter, titledAntibacterials vs. Antivirals for Colds