Flu is one of the most common reasons for sick leaves from work, school or daycare. Adults suffer from an average of two to three respiratory tract infections per year while children may have as many as 3-8. Thus, Flu is one of the most common reasons for visiting a physician. Many people come to the practice feeling very ill, hoping to find out if treatment is necessary or available. Some patients may refuse antibiotic treatment unless it has been confirmed that the illness is caused by a bacterium, while others may not believe that, for example, sinusitis or bronchitis will usually settle on its own. Many patients demand antibiotic treatment without knowing that unnecessary use of antibiotics may do more harm than good. Antibiotics may change the natural immunity in such a way that the illness may get worse or another infection will appear more easily than before. The microbiota of the gastrointestinal tract may also change. Antibiotic treatments often cause unpleasant side effects such as diarrhea and yeast infections. High doses or recurring antibiotic treatments may even require hospitalization due to complicated colitis. In addition, the increased use of antibiotics makes the bacteria more resistant.
Flu is caused by over 200 different pathogens which all cause the same kinds of unspecific symptoms such as fever, cough, rhinitis, fatigue and headache. This is why the cause of the infection is difficult or even impossible to determine based on the symptoms alone. A quick and accurate diagnosis is paramount for treating respiratory tract infections. For example, the treatment for influenza is recommended to start within 48 hours from the onset of the symptoms. The effectiveness of the treatment, however, has been shown to be significantly greater if the treatment is started within 24 hours. Research has shown that if treatment is commenced early, with children, the duration of the symptoms may be reduced up to 4 days (1). In addition to reducing the duration of the symptoms, a timely start of treatment has been shown to reduce complications linked to influenza, such as acute otitis (1).
Recent studies show that unnecessary courses of antibiotic treatment are still being prescribed excessively while antiviral treatment is not utilized in its full potential (2). A quick and accurate diagnosis would enable the use of appropriate antibiotic or antiviral drugs which is the key for improving the quality of health care.
1. Early oseltamivir treatment of influenza in children 1-3 years of age: a randomized controlled trial. Heinonen S, et al. Clin Infect Dis. 2010;51:887-94.
2. Failing our patients by suboptimally treating influenza infections. Ison MG. Clin Infect Dis. 2014;59:783-6.