I don’t know about you, but I really don’t like getting a cough, runny nose, ear ache, or plugged up sinuses. As a frequent babysitter for two cute grandkids, I get a lot more of these infections than I used to.

And as a primary care doctor for over 30 years, I have seen a lot of patients bothered by these symptoms. It is always a challenge to help people feel better.

Doctors and other primary care clinicians can prescribe medicines which help the symptoms. These include cough syrups, nasal sprays, and sometimes antihistamines or decongestants.

But one type of medicine which we are more cautious about prescribing is antibiotics. In fact, you may have already experienced going to the doctor’s office with an infection and being dismayed to be told you do not need antibiotics.

Why are doctors becoming more reserved in using antibiotics for colds, coughs, sinus infections, and ear infections?

The answer has nothing to do with saving money or cutting costs. Antibiotics are actually pretty cheap, most of the time.

There are two main reasons. One is that antibiotics are often not needed. The other is that antibiotics can actually cause you problems.

In this article I want to talk about the first reason in a little more detail. In part two, I will talk about the possible problems from using antibiotics.

Most upper respiratory infections, including sinus infections, ear infections, throat infections, and bronchitis, are caused by viruses. Even if you have green or yellow mucus, or even if you have a fever or feel very tired, the odds are that your infection is from a virus.

Antibiotics do not work against viruses, so they will not be any use. The body’s immune system can almost always fight off viruses by itself. It may take a few days or even a few weeks. But eventually your body will fight off the virus.

The best treatment is home remedies, including rest, fluids, and acetaminophen or ibuprofen for aches and pains or fevers.

If your symptoms are really bothersome, there are prescription strength medicines available to help you feel better.

But what if your respiratory infection is from a bacteria, not a virus? The normal immune system can fight off many bacterial infections also, without needing the help of antibiotics. After all, antibiotics only came into use about 80 years ago.

Prior to that time, for thousands of years, the human race survived even though infections of all kinds were pretty common.

Many people came down with bacterial infections of various kinds and were able to fight them off without antibiotics.

Over many generations, the human immune system grew stronger because it had to learn to ward off both bacterial and viral infections.

There are certainly times when antibiotics are needed to fight bacterial infections.

There are many kinds of bacterial infections which can only be cured by antibiotics. A few examples include pneumonia, blood stream infections, meningitis, bone infections, and many others.

But for common respiratory infections, such as sinus infections and ear infections, even if they are due to a bacteria, the body’s immune system can often fight them off all by itself.

In the next article, I will talk about why antibiotics can sometimes hurt you, and a little bit more about how antibiotics can best be used.

Dr. Richard Fleming is regional medical director of Partnership HealthPlan of California.