For patients · Reading time 7 minutes · Version 1.0 · Translation of the German page, medically reviewed on 6 October 2026 · the German version is authoritative · Diese Seite auf Deutsch
Colds, sore throat, cough: do I need an antibiotic?
Usually not, and that is good news. Here you will find when an infection belongs at the practice, how long it really lasts, what an antibiotic achieves and what it does not, and what actually helps you.
The essentials in three sentences
- Colds, sore throats, coughs and sinus infections are almost always caused by viruses. No antibiotic works against them.
- An infection lasts longer than you think: a week for throat and nose, up to three weeks of cough. That is normal.
- An antibiotic shortens an ordinary infection by half a day to a day and causes side effects in one in ten people.
1
Does this belong at the practice? The signpost
These signs are rare. If one applies, someone should take a look.
Tick whatever applies. If nothing applies, leave everything blank.
No warning sign: an ordinary infection
Unpleasant, but not dangerous. Your body usually manages this on its own. Below you will find what helps and how long it takes. Get in touch if a warning sign appears.
Your ticks are neither stored nor sent anywhere. This list does not apply to children under two: with fever, please always come to the practice.
2
Four pictures, and what an antibiotic achieves
For each: how to recognise it, how long it lasts, and what out of 100 people gain with an antibiotic and what they risk.
The sore throat
Medical term: pharyngitis, tonsillitis
How to recognise it
- Pain when swallowing, a red throat, sometimes white spots
- Often with a runny nose and cough: then almost always viruses
- Without cough, with fever and swollen neck glands: then more often streptococci
How long it lasts
7 days
One week. 82 out of 100 are free of symptoms after seven days even without an antibiotic.
What an antibiotic achieves here, out of 100 people
82 are over the worst after a week even without it
6 get better faster with the drug
10 get side effects: diarrhoea, rash, thrush
An antibiotic shortens a sore throat by about one day on average. After a week, only 1 in 18 gains anything.
Source: Spinks, Cochrane 2021
When it is needed after all: With signs of streptococci, a high score and fever, with scarlet fever, with swelling on one side and difficulty swallowing. We clarify that by looking at the throat and, if needed, with a rapid test.
3
Why we are sparing with antibiotics
It does not work against viruses. An antibiotic kills bacteria. In a cold there are none to kill; it only hits the useful ones in the gut.
It has side effects. Diarrhoea, nausea, skin rash, in women often thrush. In about one in ten.
It makes bacteria resistant. Every unnecessary course breeds germs against which the drug no longer works next time. That affects you yourself, not just others.
And when it is needed, we use it. For pneumonia, for streptococci with high fever, for complications. We recognise that at the practice, not on the phone. That is why there is no prescription without looking at the throat or listening to the lungs.
4
What can I do myself?
Ordered by how well it is supported by evidence.
Time and sleep
Well establishedThe immune system needs days, not hours. Sleep is the treatment that achieves the most. Bed rest is not required, taking it easy is.
Pain and fever medicines as per the package leaflet
Well establishedIbuprofen or paracetamol relieve sore throat, headache and aching limbs and lower fever. Dose and duration as in the package leaflet, without medical advice for at most three to four days. Fever does not have to go to zero; it should be bearable.
Drink and keep warm
Some studies, small effectTea, water, soup. Warm drinks noticeably relieve sore throat and cough for a short while. Two litres a day, more with fever.
Honey for cough
Some studies, small effectA spoonful of honey, neat or in tea, relieves night-time cough in studies slightly better than nothing, similar to cough syrup. Not for children under one year.
Salt water for the nose
Some studies, small effectNasal rinse or saline spray, several times a day. Loosens the mucus, moistens, without habituation.
Decongestant nasal spray
Some studies, small effectClears the nose and makes sleep possible. At most seven days, otherwise the nose gets used to it and swells up without the spray.
Lozenges
Few, small studiesLozenges or sweets stimulate saliva and relieve a sore throat briefly. Which ones does not matter.
Do not smoke
Some studies, small effectSmoke irritates the inflamed mucous membranes and prolongs the cough. An infection is a good occasion for a break, and some breaks are followed by quitting.
5
From other healing traditions
Further reading. Each item says how well it is supported by Western studies.
Chicken soup
everywhere there are chickens
Few, small studiesWarm, salty, liquid: it does the same as tea and soup, plus care. One laboratory study found a mild anti-inflammatory effect. That is evidence enough for us.
Thyme, ivy, primrose
Europe
Some studies, small effectHerbal cough remedies from the pharmacy, in some studies slightly more effective than a dummy. For a cough with phlegm.
South African geranium
South Africa
Some studies, small effectKnown as Umckaloabo. For acute bronchitis, studies show a small shortening of symptoms. The studies come mostly from the manufacturer.
Ginger, onion, garlic
Asia, Europe
Not supported by Western studiesPleasant as tea or syrup; an effect on the duration of an infection has not been shown. They do no harm.
Echinacea
North America
Few, small studiesConeflower. Many studies, contradictory results, at most a small effect. Rarely allergic reactions.
Steam inhalation
Europe
Not supported by Western studiesFeels good; the studies show no benefit for colds or sinuses. Scalds are the most common side effect, especially in children.
High-dose vitamin C and zinc
Western supplements
Few, small studiesVitamin C does not prevent colds and does not shorten them for most people. Zinc lozenges shorten them by about one day in some studies, but taste dreadful.
6
Quick check: what will you take away?
Five questions for anyone who likes. No marks.
1. Your nasal mucus has been yellow-green for three days. What does that mean?
2. How long does the cough last after bronchitis, on average?
3. What does an antibiotic achieve for ordinary bronchitis?
4. You have a sore throat with a runny nose and cough. How likely are streptococci?
5. Which sign belongs at the practice today?
No marks, no time pressure. Your progress is kept on this device only.
What this page cannot do
It makes no diagnosis and replaces no examination. It applies to otherwise healthy adults. For children under two, in pregnancy and with serious pre-existing illness, different rules apply: please contact the practice if you have a fever. This page is a translation of the German original, which is the medically reviewed version; where the two differ, the German text applies.
Version 1.0 · Translation of the German page, medically reviewed on 6 October 2026 · the German version is authoritative
Reviewed by Stefan Höhne, Facharzt für Allgemeinmedizin. Numbers, doses and emergency numbers are identical to the German version and checked automatically. If anything is unclear, the German text applies.
Sources: Spinks et al., Cochrane 2021 (sore throat); Smith et al., Cochrane 2017 (bronchitis); Lemiengre et al., Cochrane 2018 (sinusitis); Kenealy and Arroll, Cochrane 2013 (common cold); Ebell et al. 2013 (cough duration); guidelines of the German College of General Practitioners and Family Physicians (DEGAM) on sore throat, cough and rhinosinusitis. Medically responsible: Stefan Höhne, specialist in general practice (Facharzt für Allgemeinmedizin). This page is independent: no sponsor, no advertising, no brand names. All patient information (German)