"Just say no"--reducing the use of antibiotics for colds, bronchitis and sinusitis.

The use of antibiotics to treat infection can be miraculously beneficial or foolish and wasteful. Antibiotics save lives when used to treat endocarditis, meningitis and pneumonia, and restore health and prevent complications in many other infections (Figure 1). However, antibiotics provide no benefit for the common cold and in some other common respiratory tract infections their risk of adverse effects, cost, and contribution to the selection of resistant organisms outweigh their relatively trivial health benefits. Colds, upper respiratory tract infections and bronchitis are among the most common reasons to visit a doctor.1 Despite a widespread appreciation that viruses are the overwhelmingly predominant causes of these illnesses, antibiotics are prescribed surprisingly frequently. Any reduction in the use of antibiotics for these illnesses is therefore likely to make a major contribution to reducing the overall use of antibiotics in our community without placing patients at risk of adverse health outcomes.