Antivirals or antibiotics?

Confused about why you were prescribed the antibiotic amoxicillin for your sore throat or Paxlovid™, an antiviral medication, for COVID-19? Many illnesses share similar symptoms but require different medications to cure or shorten the infection. Shalika Katugaha, MD, system medical director of Infectious Diseases at Baptist Health, breaks down everything you need to know about antivirals and antibiotics.

Q: What is the difference between an antiviral and an antibiotic?

A: “Antibiotics are medications that help the immune system fight infections caused by bacteria. Antivirals are medications that help the immune system fight infections caused by viruses. Bacteria and viruses are structurally different,” Dr. Katugaha said. “So, antibiotics do not work on viruses and antivirals do not work on bacteria.”

In addition:

• Bacteria typically reproduce outside of cells, making it easier for antibiotics to target them.

• An antibiotic can often treat different types of bacterial infections and either kill the bacteria or prevent bacterial growth.

• Together with the person’s immune system, antibiotics can kill or suppress bacteria to resolve or “cure” the bacterial infection.

• Viruses live and replicate inside human cells. Viruses are more challenging to target, and therefore, antiviral medications are more challenging to develop.

• Typically, each antiviral only works against a specific virus.

• Antivirals usually do not lead to cure but lead to quicker resolution of symptoms and a shorter duration of illness.

• Both antibiotics and antivirals can be administered by mouth or intravenously (by IV).

Q: What are some examples of antibiotics?

A: “Examples of antibiotics are azithromycin, levofloxacin, ciprofloxacin, amoxicillin, cefdinir, sulfamethoxazole and trimethoprim. You may see these oral antibiotics used to treat common bacterial conditions like sinusitis, sore throat and urinary tract infections,” Dr. Katugaha said.

“There are more potent antibiotics administered through an IV that are used to treat severe infections in hospitals. Examples of these antibiotics are ceftriaxone, ceftazidime, piperacillin-tazobactam and vancomycin. In appropriate and necessary cases, infectious diseases physicians can send individuals home on antibiotics through an IV.”

Q: What are some examples of antivirals?

A: “Examples of antivirals are Tamiflu® for influenza or the flu, Paxlovid™ for COVID-19, and Valtrex® for infections caused by the herpes virus,” she said.

“More than 200 different viruses are known to cause the symptoms of the common cold, but there are no antivirals for the common cold. Recommendations for this viral infection are rest, hydration and medications to control symptoms such as over-the-counter cold and cough medications and lozenges for adults.”

Q: When would you be given an antiviral?

A: “You may be prescribed an antiviral when you are experiencing symptoms of a virus such as influenza or COVID-19. Doctors determine that you will benefit from the antiviral to shorten the course of illness and decrease symptoms,” Dr. Katugaha said.

Q: When would you be given antibiotics?

A: “Doctors prescribe antibiotics when there is high suspicion or evidence from medical tests of a bacterial infection,” she said.

Q: Can my doctor prescribe both?

A: “Yes, your doctor can prescribe both antibiotics and antivirals,” Dr. Katugaha said. “When you feel sick, please reach out to your primary care physician, who can help you figure out what type of infection you have.”

If you’re looking for personalized attention for your overall health, the experts with Baptist Primary Care are ready to help. To find the right one for you, call 904.202.4YOU (4968).