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Why Don’t Antibiotics Kill Viruses?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on March 15, 2024.

Antibiotic Resistance Overview

Overuse and inappropriate prescribing of antibiotics worldwide is leading to the global healthcare issue of antibiotic resistance. However, the issue of antibiotic resistance can be confusing for many patients. You may be told you cannot use an antibiotic for a viral infection because they are ineffective and may lead to “antibiotic resistance”.

Why don’t antibiotics kill viral infections, and how can overuse of an antibiotic lead to “antibiotic resistance”?

List of common illnesses caused by viruses

Most viral illnesses do not need special medication and are “self-limiting”, meaning your own immune system will kick in and fight off the illness. However, this can take time; a cough and cold can last from 7 to 10 days and the flu or COVID might keep you down for 1 to 2 weeks or more.

If you have tested positive for COVID-19, be sure to contact your doctor for further advice. Antiviral medications are now available for some high-risk groups with COVID-19, and vaccinations are recommended for adults and children as young as 6 months of age, with boosters if eligible.

According to the latest guidance from the CDC, if you have tested positive for COVID, you may return to normal activities without quarantine if your fever has been gone for at least 24 hours without fever-reducing medicine and your symptoms are improving. These guidelines still include measures to prevent infecting others, such as hand-washing, wearing a well-fitted mask and maintaining a distance from others.

If you come down with a viral illness, you should rest, drink plenty of fluids and treat symptoms such as fever or aches and pains. Treatment options include proper doses of pain and fever relievers like over-the-counter (OTC) acetaminophen or ibuprofen, or as directed by your doctor. If you are diagnosed with a viral illness such as a cough, cold or sore throat, and your symptoms worsen or do not clear up within 10 days, be sure to contact your doctor.

How are viruses different from bacteria?

Viruses are structurally different from bacteria. Viruses live and replicate inside of a human cell and they cannot live outside of this environment. Viruses insert their genetic material into a human cell’s DNA in order to reproduce.

Antibiotics cannot kill viruses because bacteria and viruses have different mechanisms and machinery to survive and replicate. The antibiotic has no “target” to attack in a virus.

However, antiviral medications and vaccines are specific for viruses. Vaccines stimulate your own immune system to produce antibodies, which then can “recognize” the virus to inactivate it before it can cause disease. The best way to help prevent the flu, COVID, shingles and chickenpox is with a vaccine.

Can I treat a cold with an antibiotic?

Using an antibiotic for a virus, like a cold or the flu:

Many bacterial infections do require an antibiotic; however, the type of antibiotic will vary based on the type of infection and bacteria. An antibiotic either prevents bacterial growth (bacteriostatic) or kills bacteria outright (bactericidal).

It is very important not to share your antibiotics with someone else. For example, amoxicillin (a penicillin-type drug) can be used to treat a bacterial strep throat but will not work for some common pneumonias or bladder infections.

While you may mean well if you share your medicine, the bacteria causing someone else's infection may not be susceptible to your prescribed antibiotic. In turn, those bacteria may not die and that person's infection can worsen. They may still be contagious to those around them, as well.

Plus, the person you share your antibiotic with may experience side effects or serious allergic reactions from your drug. Common antibiotic side effects include nausea, vomiting, diarrhea, vaginal yeast infections, and more. Overall, sharing any medicine with someone else is risky.

List of common illnesses caused by bacteria

How does antibiotic resistance occur?

According to the CDC, each year, at least 2.8 million people in the U.S. become infected with bacteria that are resistant to antibiotics and at least 35,000 people die as a direct result of these infections.

In general terms, antibiotic resistance can occur when bacteria learn to “fight off” the antibiotic.

Do I need to finish my antibiotic?

The bottom line: take your antibiotic for as long as your doctor tells you.

Historically you may have been told to always finish all of your prescribed antibiotic, even if you feel 100% better. The thinking was that antibiotic resistance could occur if you stop short of your full course of therapy.

But some experts are now advising that long courses are not always needed and could actually be fueling the antibiotic resistance trend. The American College of Physicians (ACP) published a guideline in 2021 entitled "ACP Best Practice Advice: Shorter course of antibiotics may be appropriate for some common infections".

Because there is no overall guiding principle, take your antibiotic for as long as your doctor states. Sometimes treatment length may need to be extended if the infection does not clear, if you are immunocompromised, pregnant, or recently had treatment for a bacterial infection.

How can vaccines help?

Many infections can be prevented by following the recommended vaccine schedule as proposed by the CDC, so be sure to keep up-to-date with your vaccines and those of your children. Your doctor and pharmacist can provide more information about important vaccines for you and your family.

Vaccines are readily available in the U.S. to help prevent the COVID-19 infection. These vaccines are safe and effective, can help keep you out of the hospital, and can help prevent severe illness and death. 

See also

Sources

  1. US Centers for Disease Control and Prevention (CDC). Antibiotic Prescribing and Use in Doctor’s Offices. Accessed March 15, 2024 at cdc.gov/antibiotic-use/community/index.html
  2. Up to Date. Patient education: What you should know about antibiotics (The Basics). Accessed March 15, 2024 at https://www.uptodate.com/contents/what-you-should-know-about-antibiotics-the-basics
  3. NPS MedicineWise. Antibiotics, Explained. Accessed March 15, 2024 at https://www.nps.org.au/consumers/antibiotics-explained
  4. Lee RA, Centor RM, Humphrey LL, et al; Scientific Medical Policy Committee of the American College of Physicians, Akl EA, Bledsoe TA, Forciea MA, et al. Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians. Ann Intern Med. 2021 Jun;174(6):822-827. doi: 10.7326/M20-7355. 

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.