Coughs, Colds & Sore Throats – Manage symptoms without antibiotics

If you have a viral infection of the ear, nose, throat, sinuses or chest, antibiotics won’t make you feel better or recover faster. Talk to your health professional about why you probably don’t need antibiotics.


Coughs, colds, earaches, sinus congestion problems and sore throats are usually caused by a virus. Antibiotics kill bacteria, not viruses. Colds usually get better in 7 to 10 days, although a cough can last up to 3 weeks.

Taking antibiotics when you don’t need them can have unwanted results.

When antibiotics are necessary, the benefits far outweigh the risks, but when they are not needed, you are taking an unnecessary risk. People taking an antibiotic may experience side effects such as diarrhoea, nausea or vomiting.

Unnecessary use of antibiotics can also lead to antibiotic resistance. This means that antibiotics are no longer effective against the bacteria they once killed. If you have an antibiotic-resistant infection you:

  • will have the infection for longer
  • may be more likely to have complications of the infection
  • could remain infectious for longer and pass your infection to other people.


In some people, especially Māori and Pacific children, sore throats can have very serious complications and do need antibiotics.

All sore throats in Māori and Pacific children and young people (aged 4–19 years) who are living in some parts of the North Island need to be checked straight away by a doctor or nurse.

Call Healthline 0800 611 116 if you are unsure what you should do.

This is because they are at risk of a serious preventable illness called rheumatic fever.  Sometimes a sore throat is caused by Streptococcus bacteria (strep throat). A strep throat can lead to rheumatic fever if it is not treated quickly with antibiotics. Rheumatic fever is a serious illness because it can cause heart damage.


Allow your immune system to fight off the virus

Use home remedies
Inhale steam from a bath or shower in a closed room to help relieve a blocked nose. Don’t inhale steam from a bowl of hot water due to the risk of burns.

Soothe your sore throat by gargling warm salty water, sucking ice cubes or throat lozenges as needed or drinking warm water with honey and lemon.

Use symptom-relieving medicines
Take over-the-counter (non-prescription) medicines such as paracetamol or ibuprofen to relieve your pain or fever.

Use a nasal or oral decongestant to relieve a blocked nose. Cough and cold medicines should not be given to children under 6 years of age and should only be given to children aged 6 to 11 years on the advice of a health professional. Saline nasal spray or drops may be used in children. For more information on symptom-relieving medicines see the Choosing Wisely resource on medicines and treatments for bronchitis.

It’s OK to ask questions
If you have questions about your symptoms or the medicines managing your symptoms, speak with your health professional.

Why was this resource developed?

This Choosing Wisely resource is based on the top five low-value practices that, based on clinical evidence, may have limited benefit, no benefit or may potentially cause harm to patients, according to the Australasian Society for Infectious Diseases[1].

Choosing Wisely is a campaign to help health professionals and patients engage in conversations about unnecessary tests and treatments and make smart and effective choices to ensure high quality care. For more information on Choosing Wisely or to see other patient materials, visit

Supporting evidence for the issues discussed in this resource

For a list of supporting evidence for the issues discussed in this resource, please see:


Antibiotic resistance:

Sore throats & rheumatic fever:


Download this resource

Developed by Choosing Wisely New Zealand, 2018. Adapted from NPS MedicineWise (2016), Coughs, colds & sore throats and New Zealand Ministry of Health webpages on “Sore throat” and “Rheumatic fever” (accessed December 2018).  Reasonable care is taken to provide accurate information at the time of creation. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. Choosing Wisely does not assume any responsibility or liability arising from any error or omission or from the use of any information in these resources.


Last updated: 16 December 2018