34-007 · EVIDENCE A · SOURCE-SENSITIVE
Don’t ask doctors for antibiotics for the common cold
普通感冒别找医生要抗生素
It costs nothing and can even save you money on medicine.
Taking antibiotics for a cold doesn’t speed up recovery compared to not taking them at all. For adults, the risk of side effects is more than twice as high when using antibiotics. For cases where nasal discharge with pus lasts less than 10 days, there is no clear benefit to taking antibiotics either.
A
Move “Don’t ask doctors for antibiotics for the common cold” to Future Me's calendar
The excuse
The routine already works until the day the source says it may not.
What feels good now
Today I keep a few minutes and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “Taking antibiotics for a cold doesn’t speed up recovery compared to not taking them at all. For adults, the risk of side effects is more than twice as high when using antibiotics. For cases where nasal discharge with pus lasts less than 10 days, there is no clear benefit to taking antibiotics either.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
7. Don’t ask doctors for antibiotics for the common cold
Cost: It costs nothing and can even save you money on medicine.
In plain terms: Taking antibiotics for a cold doesn’t speed up recovery compared to not taking them at all. For adults, the risk of side effects is more than twice as high when using antibiotics. For cases where nasal discharge with pus lasts less than 10 days, there is no clear benefit to taking antibiotics either.
Benefit: A Cochrane systematic review pooled data from 6 randomized trials involving 1,147 participants. When comparing antibiotic use to placebo for treating colds, there was no significant difference in the proportion of people who did not recover or whose symptoms persisted (RR 0.83, 95% CI 0.60–1.14, no statistically significant difference). The risk of adverse reactions was 1.8 times higher than in the placebo group (95% CI 1.01–3.21). For adults specifically, this risk was 2.62 times higher (1.32–5.18), while no increase was observed in children (RR 0.91, 0.51–1.63). For acute purulent rhinitis where nasal discharge with pus lasts less than 10 days, antibiotics also showed no clear benefit (RR 0.73, 0.47–1.13). However, the risk of adverse reactions rose by roughly 46% (RR 1.46, 1.10–1.94). The authors concluded that routine use of antibiotics is not recommended for either of these conditions.
Evidence grade: A
Sources: Kenealy T, Arroll B (2025). Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews, 11:CD000247. <https://doi.org/10.1002/14651858.CD000247.pub4>
Notes: This updated version was released in 2025; the abstract states that literature searches were conducted up to 2013. Antibiotics are prescription-only drugs in China, so pharmacies must sell them only with a valid prescription. Do not take leftover antibiotics at home without medical advice. The “moderate” rating for benefits is based on the fact that antibiotics primarily reduce the risk of adverse reactions rather than preventing death.
Read the complete Chinese source and notes
7. 普通感冒别找医生要抗生素
成本: 不花钱，还能省下药钱。
说人话: 感冒吃抗生素，好得不比不吃快。成年人吃了，副作用的风险是不吃的两倍多。流脓鼻涕不到 10 天的，吃抗生素也没有确定的好处。
收益: 一篇 Cochrane 系统综述汇总了 6 项随机试验、1147 人。感冒吃抗生素和吃安慰剂比，没好或症状持续的比例没有明显差别（RR 0.83，95% CI 0.60–1.14，差别不显著）。不良反应的风险是安慰剂组的 1.8 倍（95% CI 1.01–3.21）。其中成人 2.62 倍（1.32–5.18），儿童没有增加（0.91，0.51–1.63）。流脓鼻涕不到 10 天的急性脓性鼻炎，吃抗生素也没有明确好处（RR 0.73，0.47–1.13）。不良反应却多了（RR 1.46，1.10–1.94，高约 46%）。作者结论是：这两种情况都不推荐常规用抗生素。
证据等级: A
来源: Kenealy T, Arroll B (2025). Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews, 11:CD000247. <https://doi.org/10.1002/14651858.CD000247.pub4>
备注: 这一版是 2025 年重新发布的，摘要写明文献检索截至 2013 年。抗生素在国内是处方药，药店要凭处方卖，家里剩的抗生素也别自己拿来吃。收益定「中」是判断：它防的是不良反应，不是死亡。
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