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Antibiotics for acute respiratory infections
Last reviewed: 04.07.2025

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Many people think that there is no point in prescribing antibiotics for ARVI, since they are antibacterial drugs and do not work on viruses. So why are they prescribed anyway? Let's figure it out.
ARI is a common infectious disease that is transmitted by airborne droplets or by contact through unwashed hands, objects, things. The name of acute respiratory viral infection speaks for itself: the infection is caused by pneumotropic viruses that mostly affect the respiratory system.
Treatment of ARVI with antibiotics
If a cold is caused by a viral infection, it is more logical to take antiviral drugs at the first symptoms, conduct detoxification and symptomatic treatment as indicated. Antibiotic therapy is usually added about a week after the detection of a cold, if the treatment of a viral infection is recognized as ineffective, the patient's condition worsens or remains unchanged.
In addition, there are often situations when, against the background of decreased immunity caused by an acute respiratory viral infection, additional bacterial pathology develops. This is where the use of antibiotics becomes possible and even necessary. Antibiotics are drugs with complex and multifaceted action, their use is carried out in compliance with certain precautions: precise adherence to the dosage and time of administration, with determination of the sensitivity of the bacterial flora, with the simultaneous use of certain antifungal and immunomodulatory drugs. Therefore, the best solution when choosing an antibiotic is a preliminary consultation with a general practitioner or infectious disease specialist, who will advise you on the most effective drug specifically for your case.
Do antibiotics help with ARVI?
If within a few days after the onset of ARVI you notice the appearance of painful lymph nodes and a sore throat, plaque on the tonsils, shooting pain in the ear, prolonged purulent runny nose that does not go away, wheezing in the lungs, high temperature (more than three days), then the use of antibiotics in such cases is quite justified.
In order for antibiotics to have the expected effect, they must first be selected correctly: the spectrum of action, localization, dosage and duration of administration must be determined.
To achieve positive dynamics, cure the disease and not harm the body, it is necessary to strictly adhere to the general rules for taking antibiotics:
- the prescription of an antibiotic should be determined by the presence or possibility of a bacterial infection;
- when taking an antibiotic, its required constant concentration in the blood must be determined: if the doctor prescribed taking an antibiotic 5 times a day, then it should be taken exactly 5 times, and you should not reduce the dosage or change the treatment regimen on your own, this will unbalance your and the bacterial microflora;
- you should not stop taking antibiotics immediately after the first signs of relief, you need to complete the course of treatment: an incomplete course only weakens the strength of bacteria, and for a complete recovery they need to be completely destroyed. Without completely destroying them, you risk getting sick again soon, or acquiring a chronic form of the disease;
- when taking antibiotics, it is necessary to take measures to prevent dysbacteriosis, since these drugs can have a detrimental effect not only on pathogenic microflora, but also on healthy intestinal flora: against the background of antibiotic therapy, it is recommended to take antifungal agents, as well as drugs that support beneficial microflora in the body;
- To prevent the toxic effects of antibiotics, it is necessary to drink a sufficient amount of fluid, including fermented milk products;
- Eat more vitamins, drink juices, and spend as much time in the sun and fresh air as possible.
When are antibiotics prescribed for ARVI?
There are cases of antibiotics being prescribed for acute viral pathologies, and they are far from isolated. Of course, taking antibacterial drugs without necessity is not worth it, however, there are quite a few reasonable reasons for their prescription:
- the presence of chronic, frequently aggravated inflammation of the middle ear;
- small children with signs of unfavorable development: underweight, lack of calcium and vitamin D, weakened immunity, abnormal functioning of the body;
- the presence of symptoms of chronic weakness of the body's defense system (frequent inflammatory processes, colds, unmotivated increases in temperature, purulent processes, mycoses, constant digestive system disorders, malignant neoplasms, AIDS, congenital immune abnormalities, autoimmune pathology).
Also, the use of antibiotics is effective and understandable in some complications:
- the addition of a purulent infection (sinusitis, lesions of the lymph nodes, abscesses, phlegmon, bacterial lesions of the throat and respiratory system);
- simultaneous development of bacterial tonsillitis (purulent, with the presence of streptococcal or anaerobic infection);
- formation of background ear inflammations;
- the addition of an inflammatory process in the lungs of any etiology.
Antibiotics are often prescribed to weakened patients as a preventative measure to combat complications.
What antibiotics should be taken for acute respiratory viral infections?
Antibiotics that are usually prescribed for acute respiratory viral infections are representatives of the following groups:
- penicillin series - oxacillin, ampicillin sodium salt, ampiox - antibacterial drugs with a broad bacteriostatic and bactericidal effect, are quickly absorbed, and effectively act on pneumococcal, meningococcal, and streptococcal infections;
- cephalosporin series - cephaloridine, cephalexin, cefazolin, cefatrexil - low-toxicity antibiotics, act on gram-positive and gram-negative bacteria, suppress even penicillin-resistant strains;
- tetracycline series – tetracycline hydrochloride, morphocycline, doxycycline – inhibit protein synthesis in microbial cells, active antibacterial drugs;
- aminoglycosides – gentamicin, amikacin – popular antibiotics for severe infections;
- macrolide antibiotics – erythromycin, azithromycin – inhibit the growth of bacteria;
- other groups of antibiotics – lincomycin, rifampicin.
The choice of antibiotic is determined by its spectrum of action, the degree of influence on the bacterial cell. Before taking the drugs, carefully read the instructions, and even better, consult a doctor.
Antibiotics for ARVI in adults
Antibiotics are usually not prescribed from the first days of the disease. Viral etiology of ARVI requires the use of antiviral drugs (rimantadine, zanamivir) first of all.
Antibiotic therapy in adults is used when the following symptoms are detected:
- prolonged (more than three days) high body temperature;
- symptoms of general intoxication of the body (headache, dizziness, nausea, cyanosis);
- wheezing, difficulty breathing, inability to cough up the contents of the bronchi, heaviness behind the breastbone;
- increased erythrocyte sedimentation rate (ESR);
- increased number of leukocytes in the blood;
- the appearance of visible foci of microbial infection (phlegmon, abscesses, boils, purulent sinusitis);
- lack of positive dynamics in the development of the disease (despite treatment, pathological symptoms progress);
- old age and weakened immune system of the body.
Antibiotics are prescribed for ARVI in adults, also in mixed and complicated forms of the disease.
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Antibiotics for acute respiratory viral infections in children
Many parents, when their child develops an acute respiratory viral infection, rush to give him or her an antibiotic, sometimes without any reason. There is no need to rush with antibiotic therapy, especially when it comes to children.
Here are some principles according to which antibiotics are prescribed for acute respiratory viral infections in children:
- antibiotics are used only when there is a high probability or proven bacterial etiology of the pathological condition;
- When determining an antibiotic for treatment, the most likely pathogens of the infectious disease are taken into account, and the possibility of the child having undergone antibacterial therapy for some other disease recently is clarified;
- the choice of therapeutic intervention for a child involves the administration of drugs with a low level of toxicity;
- many antibacterial drugs have their own age restrictions for use;
- Dosing of antibiotics for children is usually based on the child's overall body weight.
Uncomplicated forms of ARVI usually do not require the use of antibiotics. They are prescribed for concomitant inflammation of the maxillary sinuses, tonsillitis, otitis, and signs of pneumonia.
Antibiotics for acute respiratory viral infections and flu
Influenza is essentially the same viral infection, characterized, unlike ARVI, by a more abrupt onset and the possibility of developing more serious complications.
Let's return to the question: are antibiotics equally necessary for ARVI and flu?
The influenza pathogen is also a virus, so unmotivated prescription of antibiotic therapy for influenza is not welcomed. Firstly, this is an additional toxic effect on the liver and gastrointestinal tract, and secondly, the possible development of resistance of bacterial flora to the antibiotic.
Antibiotic therapy should be added to symptomatic and antiviral therapy only in cases of prolonged, persistent fever, chronic respiratory diseases, kidneys, cardiovascular system, diabetes, and decreased immune defense. Antibiotics may be prescribed to prevent the existing risk of developing a secondary bacterial infection.
You should start taking antibiotics only as prescribed by your doctor; you should not take them on your own or without justification.
List of antibiotics for ARVI
The following are considered to be some of the most effective antibacterial drugs for ARVI:
- The cephalosporin series includes cephexin, ceporin, apsetil - semi-synthetic drugs with a wide spectrum of action. Three generations of these drugs are known. The bacteriostatic effect allows the use of these antibiotics for any infectious diseases of the respiratory system. Adults can take the drugs in a daily dose of 400 mg, divided into two doses. The course of treatment is 1-2 weeks;
- The fluoroquinolone series is represented by moxifloxacin and levofloxacin, which are characterized by rapid absorption and good bactericidal action. Adults are prescribed 0.5 g per day. Not recommended for use in pediatric practice;
- The macrolide series is represented by erythromycin, azithromycin, used for sinusitis, tonsillitis, otitis media, pneumonia. It is allowed to take these drugs during pregnancy. Take 5-6 times a day, 0.25 g;
- The penicillin series consists of antibiotics derived from penicillin: ampicillin, amoxicillin, oxacillin. They can be used in pediatrics, as they have a low degree of toxicity. The daily dose is from two to three grams, taken 4 times.
The course of antibiotic therapy is 1-2 weeks, but not less than five and not more than 14 days.
If one antibiotic is ineffective, it should be replaced as soon as possible with another one with a stronger degree of activity against bacteria.
If an allergic reaction to an antibiotic develops, you should visit a doctor to replace the drug with a drug from another group.
The best antibiotic for ARVI
Unfortunately, it is impossible to say for sure what the best antibiotic for ARVI should be. The selection of an antibiotic is carried out individually, taking into account the degree of infection, the age and condition of the patient, the sensitivity of the bacterial flora and the patient's allergy history. If there was one best antibiotic, there would be no point in all other antibacterial agents.
However, antibiotics are divided into conventional (penicillin, tetracycline, chloramphenicol, erythromycin) and stronger (ceftriaxone, unidox, sumamed, rulid, etc.) according to the degree of impact on the microbial cell.
When treating infectious diseases of mixed etiology, it is necessary to choose not just strong antibacterial agents, but antibiotics that are active against the widest possible range of pathogens. Sometimes, to achieve the maximum breadth of action, it is possible to prescribe combinations of drugs with different antibacterial spectra.
It is no secret that new generation drugs have a much higher degree of activity and have fewer side effects than antibiotics, for example, thirty years ago. Such drugs are clarithromycin (Clabax, along with the effect on bacteria, helps improve immunity), as well as sumamed (aka azithromycin, has the property of a stable effect on bacterial strains).
The drugs can be taken orally, or as an injection or spray.
Many people prescribe antibiotics to themselves at the slightest sign of any disease. This is wrong, since the unreasonable and unqualified use of antibiotics provokes rapid growth and mutations of bacterial cells, which significantly reduces the effect of antibacterial agents.
Antibiotics for acute respiratory viral infections should not be taken without supervision, also because these drugs act not only on specific bacteria, but on the entire body as a whole.
Attention!
To simplify the perception of information, this instruction for use of the drug "Antibiotics for acute respiratory infections" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.