Your Health: Winter respiratory infection advice
by Terry Hollenbeck, M.D.
Jan 17, 2013 | 3686 views | 1 1 comments | 9 9 recommendations | email to a friend | print

The winter respiratory, cold and flu season is upon us. I have seen quite a spike in visits to urgent care by people suffering from coughs, nasal and sinus congestion, sore throats and generalized achiness. 

I believe that people, now more than ever, realize that there is no cure for the common upper-respiratory infection, also known as URI or head and chest cold.

I am sympathetic to anyone who feels ill, and I understand the desire to feel well as soon as possible, but there just is no quick fix to the common upper-respiratory infections, including bronchitis.

Unless one’s symptoms last longer than expected, as I will describe below, antibiotics will do no good and may even cause unwanted side effects and help create germs that are resistant to antibiotics.

Here are some situations in which someone with upper-respiratory symptoms should be seen by a doctor:

- You have a fever of 103 degrees Fahrenheit or higher.

- You have any fever lasting more than three days.

- Your cough is associated with wheezing, chest pain or shortness of breath.

- You are elderly or have a compromised immune system due to chronic disease or chemotherapy.

- You have vomiting for more than one day and cannot keep down any liquids, or you have profuse diarrhea.

- You are basically well, except that you have a cough for two to three weeks.

- Your sinus congestion with green mucus doesn’t improve after seven to 10 days.

Most coughs, even with yellow or green mucus, are considered bronchitis and are caused by viruses that cannot be cured with antibiotics. A recent large study concluded that bronchitis can last as long as three weeks. If your cough lasts longer, you should see a doctor.

Another reason to see a doctor is if you have a cough associated with fever, shortness of breath and feeling as if you’ve been run over by a Mack truck — you might have pneumonia or influenza. Treatment is available for many who have these illnesses.

Regarding sinusitis: Almost all sinus infections, even with green mucus production, begin as a common viral infection and will improve without antibiotics. If symptoms last more than seven to 10 days, then an antibiotic may be indicated.

When you do see your doctor, let him or her evaluate you by listening to what you have to say, examining you and then determining what type of treatment is necessary to make you feel better.

PS: It’s not too late for the flu shot. Influenza cases are just beginning in our area, and as is happening in other parts of the country, this disease may spread among us quickly. Better safe than sorry.

- Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website,, or email him at Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.

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Richard Parker
January 20, 2013
Very glad to see enlightened advice about the overuse of antibiotics.

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