Antibiotics: When You Need Them, When You Do Not and How to Take Them Safely

A fever, a cough, a sore throat, and within hours someone at home suggests an antibiotic. In Pakistan, antibiotics are among the most widely misused medicines. They are bought without prescriptions, stopped too early, shared between family members, and taken for viral illnesses where they do nothing. The result is a growing problem called antibiotic resistance, where infections that were once easy to treat stop responding.

This guide explains what antibiotics do, when they are needed and when they are not, how to take them correctly, common side effects, and how to protect these medicines for the future.

What are antibiotics?

Antibiotics are medicines that kill bacteria or stop them from multiplying. They work only against bacterial infections. They do nothing against viruses, which cause colds, flu, most coughs and sore throats, many ear and chest infections, and dengue.

When are antibiotics needed?

• Bacterial infections confirmed or strongly suspected by a doctor, such as strep throat, many urinary tract infections, bacterial pneumonia, typhoid and some skin and wound infections.
• To prevent infection in some surgeries or in people at high risk.
• When tests, such as a urine culture or throat swab, show a bacterium.

When they are not needed

• Common cold and flu. See our guide to flu season in Pakistan.
• Most sore throats, coughs and bronchitis in healthy people. See our guides to sore throat and dry cough vs wet cough.
• Most diarrhoea and vomiting, which are caused by viruses. Rehydration comes first.
• Dengue and other viral fevers. See dengue symptoms and warning signs.
• Many ear aches in children, which often settle by themselves, although a doctor may advise treatment.

Why misuse is a problem

Every time we take an antibiotic, some bacteria in the body survive and learn to resist it. These resistant bacteria then multiply and can spread to other people. Overuse and misuse of antibiotics speed this up. The result is infections that need stronger, costlier, more toxic medicines, longer hospital stays and, sometimes, no effective treatment at all. This is already a serious problem in Pakistan, as seen with extensively drug-resistant typhoid. Read about this in our guide to typhoid fever in Pakistan.

How to take antibiotics correctly

• Take them only when prescribed by a doctor for your current illness.
• Follow the instructions exactly: the right amount, at the right times, for the right number of days. Set phone reminders if you need to.
• Finish the course unless your doctor tells you to stop. Stopping when you feel better can leave some bacteria behind. If you have a bad reaction, call your doctor instead of simply stopping.
• Do not save leftovers for the next illness, and do not use old prescriptions.
• Do not share them with family or friends. The right antibiotic depends on the infection and the person.
• Take them with or without food as directed. Some work better on an empty stomach, others need food to avoid stomach upset.
• Avoid alcohol with certain antibiotics, such as metronidazole.
• Tell your doctor about allergies, pregnancy, breastfeeding and any other medicines you take.

Common antibiotics you may hear about

Doctors choose an antibiotic according to the infection, the person and local resistance. Information pages on our site include amoxicillin, co-amoxiclav, azithromycin, clarithromycin, ciprofloxacin and cefixime. These are all prescription medicines, and the right choice and duration is a medical decision. Never choose one yourself from a friend’s advice or an old strip.

Khasmart sells antibiotics only against a valid prescription. If you have one, you can upload your prescription. See the bacterial infections category for the range.

Side effects to know about

• Nausea, stomach upset, diarrhoea. Taking the dose with food may help if the leaflet allows it.
• Thrush (a yeast infection) in the mouth or vagina.
• Rash or itching. Stop the medicine and contact your doctor.
• A serious allergic reaction: swelling of the face, lips or tongue, wheezing, difficulty breathing or a severe rash. This is an emergency. Go to hospital.
• Severe or bloody diarrhoea during or after a course. See your doctor.
• Some antibiotics affect sun sensitivity, tendons or the heart rhythm. Read the leaflet.

Some women find that antibiotics reduce the effect of certain contraceptive methods. Ask your doctor.

What you can do to protect antibiotics

• Do not ask for antibiotics for colds, flu and most coughs. Accept advice if the doctor says you do not need one.
• Wash your hands, and keep vaccinations up to date, to prevent infections in the first place. See our guide to hand washing.
• Drink safe water, and prepare food hygienically. Read about waterborne diseases.
• Do not buy antibiotics over the counter or from unlicensed shops.
• Dispose of unused antibiotics safely and do not flush them.
• Ask your doctor whether a test could show which antibiotic is best.

When to see a doctor

• A fever that lasts more than three days, or is very high.
• Symptoms that worsen after the first few days, or return after getting better.
• Green or yellow phlegm with breathlessness, chest pain or high fever.
• Painful, burning urine, or pain in the back or side.
• A wound that is red, swollen, hot or has pus.
• A baby or a very young child with fever.
• You are not improving 48 to 72 hours after starting antibiotics.

Frequently asked questions

Do green phlegm or a yellow nose mean I need antibiotics?

Not always. Colour can change during a viral infection too. The doctor will decide based on other symptoms.

Can I stop antibiotics when I feel better?

Follow your doctor’s instructions. For many infections, completing the prescribed course is important. Some short courses are designed to be brief, so always ask.

Can I take probiotics or yoghurt with antibiotics?

Many people do to ease stomach upset. Take probiotics a couple of hours apart from the antibiotic, and ask your pharmacist.

Is it okay to take the same antibiotic again for a similar illness?

No. Different infections need different treatment, and leftovers are usually not a full course.

You can order prescribed medicines from Khasmart with delivery across Pakistan.

This article is for general information and is not a substitute for advice from your doctor or pharmacist. It does not include dosage; always follow the directions on the pack or from your doctor.