You have a cold, or feel a sore throat coming on. What do you do? Call your doctor to ask for an antibiotic? Hopefully, not. Most sore throats are not the result of bacterial infections. Colds often begin with a sore throat, but they are the result of viruses, not bacteria. In other words, an antibiotic will not help the problem.

The idea of taking a pill to treat illness and discomfort is a common one among Americans, but when that pill is an antibiotic taken for conditions that the drug won't touch, it is worse than useless — it contributes to antibiotic resistance. And the result is that what could be a life-saving drug becomes far less effective when it is actually needed.

One in four prescriptions for antibiotics go to patients who don't need them and won't benefit from them, according to a recent study.

By looking back at the diagnosis a patient was given on the day they received a prescription for an antibiotic, the team was able to see if the use of antibiotics was justified.

This rise in unnecessary antibiotic prescriptions is up from what it was during the pandemic, researchers from the University of Michigan, Northwestern University and Boston Medical Center found. Data came from more than 37.5 million children and adults covered by private insurance or Medicare Advantage plans from 2017 to 2021 — a period that encompassed the COVID-19 lockdowns.

All the participants had received antibiotic prescriptions from both in-person and telehealth visits.

By looking back at the diagnosis a patient was given on the day they received a prescription for an antibiotic, or in the three days prior to getting the prescription, the team was able to see if the use of antibiotics was justified. If it did not, they classified the prescription as inappropriate.

After an initial dip during the pandemic, with people reluctant to seek healthcare for non-COVID issues, unnecessary prescriptions for antibiotics rose again in 2021.

“Our study shows that the decline in exposure to inappropriate antibiotic prescriptions during the pandemic was only temporary,” lead author Kao-Ping Chua, a pediatrician and health care researcher in the Department of Pediatrics at the U-M Medical School, said in a statement. “Our findings highlight the continued importance of quality improvement initiatives focused on preventing unnecessary antibiotic prescribing and antimicrobial resistance, which kills 48,000 Americans per year.”

Among the study's other findings on unnecessary antibiotic use:

  • The percentage of inappropriate antibiotic prescriptions rose from 25.5 percent to just over 27 percent during the five years of the study.
  • Certain groups were more likely to receive inappropriate antibiotics. Thirty percent of antibiotics for older people with Medicare Advantage coverage were inappropriate at the end of 2021 in contrast to unnecessary antibiotic prescriptions for adults with private health insurance (26 percent) and antibiotics for children with private insurance (17 percent).
  • One of the most common reasons for seeking prescriptions for antibiotics from March 2020 through December 2021 was “Contact with and suspected exposure to COVID-19&rdquo. COVID is caused by a coronavirus, making these prescriptions an inappropriate use of antibiotics.

If you avoid making antibiotics the default cure for what ails you, they will be more likely to benefit you when you do need them. Bacterial infections requiring antibiotics are usually accompanied by fever. Take your temperature. Fever is not usually high in viral infections. Try honey to ease any throat inflammation and give a sore throat a little time to improve before concluding you need antibiotics and calling your doctor.

The study is published in Clinical Infectious Diseases.