Choosing Wisely - Coughs, colds and sore throats

Do you need a medicine?

Coughs, colds, earaches, sinus congestion problems and sore throats are usually caused by a virus. Antibiotics kill bacteria, not viruses. Colds usually get better in 7 to 10 days, although a cough can last up to 3 weeks.

Taking antibiotics when you don’t need them can have unwanted results.

When antibiotics are necessary, the benefits far outweigh the risks, but when they are not needed, you are taking an unnecessary risk. People taking an antibiotic may experience side effects such as diarrhoea, nausea or vomiting.

Unnecessary use of antibiotics can also lead to antibiotic resistance. This means that antibiotics are no longer effective against the bacteria they once killed. If you have an antibiotic-resistant infection you:

• will have the infection for longer
• may be more likely to have complications of the infection
• could remain infectious for longer and pass your infection to other people.

When does a sore throat need antibiotics?

In some people, especially Māori and Pacific children, sore throats can have very serious complications and do need antibiotics. This is because these groups are at risk of a serious preventable illness called rheumatic fever. Sometimes a sore throat is caused by Streptococcus bacteria (strep throat). A strep throat can lead to rheumatic fever if it is not treated quickly with antibiotics. Rheumatic fever is a serious illness because it can cause heart damage.

Call Healthline on 0800 611 116 if you are unsure what you should do.

What can you do?

• Rest. Allow your immune system to fight off the virus
• Use home remedies. Inhale steam from a bath or shower in a closed room to help relieve a blocked nose. Don’t inhale steam from a bowl of hot water due to the risk of burns. Soothe your sore throat by gargling warm salty water, sucking ice cubes or throat lozenges as needed or drinking warm water with honey and lemon.
• Use symptom-relieving medicines. Take over-the-counter (non-prescription) medicines such as paracetamol or ibuprofen to relieve your pain or fever. Use a nasal or oral decongestant to relieve a blocked nose. Cough and cold medicines should not be given to children under 6 years of age and should only be given to children aged 6 to 11 years on the advice of a health professional. Saline nasal spray or drops may be used in children. For more information on symptom-relieving medicines see the Choosing Wisely resource on medicines and treatments for bronchitis.

It’s OK to ask questions
If you have questions about your symptoms or the medicines managing your symptoms, speak with your health professional.

You can also download this information as a PDF (454 KB).

Further information

Antibiotics: Health Navigator
Antibiotic resistance: Health Navigator, Ministry of Health

Adapted from NPS MedicineWise (2016), Coughs, colds & sore throats. Reasonable care is taken to provide accurate information at the time of creation. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. NPS MedicineWise and Choosing Wisely New Zealand do not assume any responsibility or liability arising from any error or omission or from reliance on any information in this resource.