Use of antibiotic in common cold

Use of antibiotic in common cold
Treatment with antibiotics for uncomplicated upper respiratory tract infections causes more harm than benefit. A systematic review of randomized trials in people with upper respiratory symptoms for less than seven days found that rates of persistence of symptoms was identical in subjects who received antibiotics as in those who received placebo.
Many patients and clinicians erroneously place considerable importance upon the color of nasal discharge when making decisions about antibiotic use. In fact, colored nasal discharge is a normal self-limited phase of the uncomplicated common cold. The systematic review cited above found that the relative risk for persistent acute purulent rhinitis was less in patients treated with antibiotic treatment compared to those receiving a placebo; however the increased risk of adverse effects in those receiving antibiotic outweighed the minimal effect of treatment.
Nasal cultures can theoretically identify the small subset of patients with common colds complicated by bacterial infections due to organisms such as H. influenzae, M. catarrhalis, or S. pneumoniae. However, such cultures require several days to return, and a proportion of patients with positive cultures will almost surely have coincidental colonization rather than true infection.
The potential benefit of such nasal cultures was examined in a double-blind, placebo-controlled trial involving 314 patients who presented with symptoms typical of the common cold symptoms. Subjects were randomly assigned to receive five days of treatment with amoxicillin-clavulanate (375 mg three times daily) or placebo. 72 of 300 patients who had nasal aspirates performed had negative bacterial cultures, 167 had cultures that were positive only for bacteria not responsible for respiratory infections, and 61 had cultures positive for H. influenzae, M. catarrhalis, or S. pneumoniae. Antibiotic therapy benefited only those in the last group; 27 percent of those in the latter group versus 4 percent of placebo-treated patients had better symptoms scores. Because the majority of cultures of nasal discharge taken from patients with colds are negative or reveal non-pathogenic bacteria, and because results of cultures are not immediately available to guide treatment, we believe that cultures of nasal secretions in patients with the common cold are cost-ineffective, impractical and unnecessary.
It is important to note that approximately 0.5 to 2 percent of adult patients with colds and influenza-like illnesses develop acute bacterial sinusitis.
Some experts have suggested that macrolide antibiotics may have a beneficial effect in the treatment of the common cold by reducing inflammatory mediators such as interleukin (IL)-6 or IL-8. However, a prospective randomized study involving 24 healthy volunteers who consented to experimental nasal inoculation with rhinovirus 16 showed no difference in intensity or duration of cold symptoms, weight of nasal secretions, decrease in nasal peak flow, or concentrations of IL-6 or -8 in nasal fluid in patients treated with clarithromycin versus trimethoprim-sulfamethoxazole.
So antibiotic are not effective in the treatment of the common cold and should not be prescribed and Symptomatic therapy remains the mainstay of common cold treatment.