This information is useful for patients aged 3 months old and above presenting with respiratory tract infections (RTIs) where there is no immediate need for an antibiotic. This information is intended as general guidance and does not replace individual medical advice. Always follow the recommendations of your healthcare professional.
- Antibiotics do not work for viral infections such as colds and flu, and most coughs.
- Colds, most coughs, many sore throats, and most cases of sinusitis are caused by viruses. Ear infections in children are often triggered by viral illnesses and many improve without antibiotics.
- Your body can usually fight these infections on its own.
- Your doctor will assess whether you need an antibiotic.
Your Infection – Symptoms commonly last for:
- Middle-ear infection: 3-7 days
- Sore throat: 7 days
- Common cold: 14 days
- Sinusitis: 14-21 days
- Cough or bronchitis: 21 days
Young children, particularly those attending creche or daycare, may experience 6-10 respiratory infections each year, especially during the first few years of exposure. It is not a reflection of poor parenting or a weak immune system. Rather, children are gradually building a “library” of immune responses that helps protect them as they grow older.
How to look after yourself and your family
- Have plenty of rest to help you get better.
- Drink enough fluids to avoid feeling thirsty.
- Ask your local pharmacist to recommend medicines to help your
symptoms or pain (or both). - Fever is a normal response from the body to infection. The goal is not necessarily to eliminate the fever completely, but to keep the patient comfortable and well hydrated. You can use paracetamol if you or your child are uncomfortable because of a fever.
- Cover your coughs and sneezes. Use a tissue and place it immediately
in the bin. Cough or sneeze into your upper sleeve, not into your hands. - Hand hygiene is essential to help prevent spread of infection to your
family, friends and others you meet. Wash your hands with soap and
water or use alcohol-based hand sanitiser. - For reliable South African information about influenza and other respiratory infections, visit the National Institute for Communicable Diseases (NICD) at www.nicd.ac.za.
Why you should only take antibiotics when needed
The unnecessary use of antibiotics contributes to antibiotic resistance, meaning that these medicines may become less effective when they are genuinely needed for serious infections. Antibiotics can cause side effects such as rashes, thrush, stomach pains, diarrhoea, reactions to sunlight and other symptoms. If you are concerned, seek medical advice.
Sometimes antibiotics are still important. Your doctor may recommend antibiotics if there is evidence of a bacterial infection, if symptoms are severe or prolonged, or if you or your child have underlying medical conditions that increase the risk of complications.
If your condition does not improve
In certain circumstances, your GP may prescribe an antibiotic, as a back-up, in case your condition does not improve after a few days. If you feel better, you do not need to fill the prescription. However, if you do not feel better in a few days, then fill your back-up antibiotic prescription at the pharmacy. If symptoms get worse or your level of concern is increasing, seek urgent medical attention. Refer to ‘When to seek urgent medical attention’ section of this leaflet.
Go back to your GP if:
- You are not starting to improve by the timeframes given in the “Symptoms commonly last for” section.
- Your child has a middle ear infection and there is fluid coming out of their ear/s.
When to seek urgent medical attention
How an infection progresses can sometimes be difficult to predict. If you or your child are getting worse or are sicker than you would expect, trust your instincts and seek medical advice urgently from your GP, local clinic or casualty.
Red flag signs and symptoms in CHILDREN are:
- Very fast breathing or difficulty breathing with flaring nostrils and deep recesses between ribs
- Fits or convulsions
- Mottled skin (irregular colour) bluish or pale
- A rash that does not fade when you press it
- Unusually sleepy and difficult to wake
- Unusually cold when you touch them
- Persistent vomiting or inability to keep fluids down
- Has had no pee or wet nappy for more than 12 hours or a very dry mouth and no tears
- Symptoms that suddenly worsen after initially improving
In addition, in children under 5 years: not feeding or else vomiting repeatedly
Babies younger than 3 months: a fever of 38oC or more should prompt an urgent assessment by a healthcare professional.
Red flag signs and symptoms in ADULTS are:
- Slurred speech, new confusion, too sick to communicate, drowsy
- Extreme shivering, muscle aches, fever
- Has not passed urine in the last 12 hours
- Persistent vomiting or inability to keep fluids down
- Shortness of breath, lips tinged with blue
- Chest pain or severe pain when breathing
- Feels like your heart is racing, dizzy when you sit or stand
- Feeling a lot worse. “I feel like I’m going to die”
- Skin mottled and discoloured, new rash that is still visible when pressed on with a clear glass (glass test).
How to prevent spreading respiratory infections
- Wash your hands regularly.
- Cover coughs and sneezes.
- Stay home from work, school, or crèche when you have a fever.
- Ensure good ventilation indoors.
- Keep up to date with recommended vaccinations, including influenza vaccination for high-risk individuals.
