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 Antibiotics and pandemic flu

The risk of misusing antibiotics is increased by the threat posed by pandemic flu [1]. Antibiotics are not the solution for infections caused by viruses, including pandemic flu. Antibiotics are effective only against bacterial infections. A diagnosis about your infection and the decision about whether antibiotics are necessary can only be made by a medical doctor.

Remember: Do not self-medicate with antibiotics for pandemic influenza A(H1N1)v

  • Antibiotics do not work against viruses, including pandemic influenza A(H1N1)v.
  • Antibiotics do not stop pandemic influenza A(H1N1)v and other viruses from spreading to other persons.
  • Taking antibiotics for wrong reasons, such as against flu, has no benefit for you [2], may give you side effects such as diarrhoea [2, 3, 4, 5] and will promote antibiotic resistance in bacteria [6, 7, 8]. So, when you need antibiotics in the future they may no longer work [9].
  • Bacterial pneumonia is a possible complication of flu, including pandemic influenza A(H1N1)v [1]. Patients with such a complication need antibiotics [10] which should only be prescribed by their doctor.
  • Always seek your doctor’s advice before taking antibiotics.


Call your doctor if:

  • You (or your child) get the flu and are in a particular risk group, i.e.: 

    - have a chronic underlying illness (asthma or chronic obstructive pulmonary disease (COPD), diabetes, immunosuppression,     chronic cardiovascular disease (not simple high blood pressure), chronic renal failure, seizure disorder and cancer) 
    - you are pregnant 
    - your child is under two years of age
  • You (or your child) have severe symptoms.
  • You (or your child) get the flu and symptoms do not get better or get worse.


More information about:


 [1] -  Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis. 2008;198(7):962-70.
[2] - Fahey T, Stocks N, Thomas T. Systematic review of the treatment of upper respiratory tract infection. Arch Dis Child 1998;79(3):225-30.
[3] - Arroll B, Kenealy T. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD000247.
[4] - Fahey T, Smucny J, Becker L, Glazier R. Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD000245.
[5] - Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis 2008;47:online. DOI: 10.1086/591126.
 [6] - Malhotra-Kumar S, Lammens C, Coenen S, Van Herck K, Goossens H. Effect of azithromycin and clarithromycin therapy on pharyngeal carriage of macrolide-resistant streptococci in healthy volunteers: a randomised, double-blind, placebo-controlled study. Lancet 2007;369(9560):482-90.
[7] - Donnan PT, Wei L, Steinke DT, Phillips G, Clarke R, Noone A, Sullivan FM, MacDonald TM, Davey PG. Presence of bacteriuria caused by trimethoprim resistant bacteria in patients prescribed antibiotics: multilevel model with practice and individual patient data. BMJ 2004;328(7451):1297-301.
[8] - London N, Nijsten R, Mertens P, v d Bogaard A, Stobberingh E. Effect of antibiotic therapy on the antibiotic resistance of faecal Escherichia coli in patients attending general practitioners. J Antimicrob Chemother 1994;34(2):239-46.
[9] - Daneman N, McGeer A, Green K, Low DE; for the Toronto Invasive Bacterial Diseases Network. Macrolide resistance in bacteremic pneumococcal disease: implications for patient management. Clin Infect Dis 2006;43(4):432-8.
[10] -  McCullers JA, English BK. Improving therapeutic strategies for secondary bacterial pneumonia following influenza. Future Microbiol. 2008;3:397-404.

© European Centre for Disease Prevention and Control (ECDC) 2005 - 2015