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JAMA Patient Page
May 28, 2003

Coughs, Colds, and Antibiotics

JAMA. 2003;289(20):2750. doi:10.1001/jama.289.20.2619

The common cold, also known as an upper respiratory tract infection, occurs more than 1 billion times each year in the United States. Most adults can expect to have 4 to 6 colds per year. Children often have more than 9 colds per year, especially if they attend child-care facilities, where they are exposed to other children with colds. The May 28, 2003, issue of JAMA includes an article about upper respiratory tract infections and proper use of antibiotics.


Colds are caused by viruses. Cold viruses can be spread through the air by droplets from a sneeze or cough but are primarily spread by touching your nose, eyes, or mouth after contact (for example, shaking hands) with someone who has the cold virus. You do not catch a cold from exposure to cold weather or by being chilled or overheated.

Two or three days after infection with a cold virus, symptoms develop. Runny nose, sneezing, nasal stuffiness, scratchy throat, mild fatigue, slight fever, and dry cough are all symptoms of a common cold. You are infectious (can spread the cold) to other people before you know you have a cold.


  • Wash your hands frequently, especially if you or your children have a cold.

  • Avoid close contact with anybody who has a cold.

  • Use a tissue when you cough or sneeze from a cold and throw the tissue away immediately.

  • Wash your hands after blowing your nose or sneezing into your hand.

  • Stay at home and rest if you have a cold. Your body needs rest to recover from a cold, and you can avoid giving the cold to others.


Antibiotics are not useful for treating colds because they only kill bacteria, not viruses. The inappropriate use of antibiotics is a major factor in causing bacteria to become resistant to antibiotics that previously were able to kill them. Antibiotic resistance is a growing problem around the world. Bacteria with antibiotic resistance can cause serious illness and death.


  • Do not ask your doctor for antibiotics if you have a cold.

  • If antibiotics are prescribed for a bacterial infection, take them exactly as you are instructed. It is important to take the full course of antibiotics.

  • Do not share antibiotics with anyone else.

  • Do not take antibiotics as a preventive measure against bacterial infection when you have a cold. This does not help you prevent a bacterial infection.

Usually cold symptoms last for 1 to 2 weeks, although chest colds (bronchitis) typically last 2 to 3 weeks. If your symptoms are not improving after 1 to 2 weeks, you may have an allergy, a complication of a cold, or some other reason for your symptoms. You should contact your doctor if your cold symptoms do not improve after 2 weeks, or anytime during your illness if you develop a high fever; have difficulty breathing or swallowing; or experience severe headache, severe fatigue, or a rash.



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at Many are available in English and Spanish. A Patient Page on strep throat was published in the December 13, 2000,issue

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

Sources: Centers for Disease Control and Prevention, American Academy of Pediatrics, National Institute of Allergy and Infectious Diseases