Don't ask a doctor for antibiotics for an ordinary cold

High value
Evidence A
Buys life
Free
Takes minutes
No willpower

In plain words

Taking antibiotics for a cold doesn't make you better any faster than not taking them. Adults who took them had more than twice the risk of side effects of those who didn't. For a runny nose with pus lasting under 10 days, antibiotics also have no definite benefit.

Cost: Free, and it saves the cost of the medicine.
What you get: A Cochrane systematic review pooled 6 randomized trials with 1147 people. For antibiotics versus placebo in the common cold, there was no clear difference in the share who did not get better or whose symptoms persisted (RR 0.83, 95% CI 0.60–1.14, not a significant difference). The risk of adverse effects was 1.8 times that of the placebo group (95% CI 1.01–3.21). Among adults it was 2.62 times (1.32–5.18), and in children there was no increase (0.91, 0.51–1.63). For acute purulent rhinitis (a runny nose with pus) lasting under 10 days, antibiotics also had no clear benefit (RR 0.73, 0.47–1.13). But adverse effects were more frequent (RR 1.46, 1.10–1.94, about 46% higher). The authors concluded that routine antibiotics are not recommended for either condition.
Notes: This version was republished in 2025, and the abstract states that the literature search ran to 2013. In China antibiotics are prescription drugs, and drugstores must sell them against a prescription; don't take leftover antibiotics at home on your own either. The benefit is rated “medium” as a judgment: what it guards against is adverse effects, not death.
Evidence grade: A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources: Kenealy T, Arroll B (2025). Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews, 11:CD000247. https://doi.org/10.1002/14651858.CD000247.pub4

Mentioned in

Clear out expired and unused leftover medicines on a regular schedule, and drop them with their packaging into the hazardous waste bin; don't keep them at home

Translated from the Chinese original. Original book, section 34, tip 7. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer