Medical Conditions That Do Not Need Antibiotics, by Dr. Bob

The subject of what not to treat comes up so often in medicine that books have literally been written about the subject both for medical and non-medical folks. I decided to break it down head to toe and try to approach it with a common sense approach.

Headaches do not need antibiotics. If an infection is due to bacteria, if it causes headache alone…that would be really unusual and probably cause the person’s death. Some bacterial meningitis infections will benefit from antibiotics, but figuring this out in time and having the right antibiotics is just not realistic. Now, headaches can be caused by viruses and can accompany other symptoms that do need antibiotics, but headaches alone do not need antibiotics for treatment. 

Eyes: pinkeye needs cleaning and time. Almost none of the pinkeye treatment that goes on daily in medicine is necessary. Almost all pinkeye is viral and antibiotics are not needed. Get a clean washcloth warm and wipe the eye gently from the nose out to the ear about 4-to-6 times a day to clear out the gunk. Babies are an exception and will be ignored for this article, so don’t freak out pediatrics nurses.  

Nose: Sniffles are a cold, end of story. Do not treat colds and coughs with antibiotics unnecessarily or you will run out in short order. Colds are over-treated nearly all the time with antibiotics because doctors don’t want to make mommies mad and are trying to keep people happy. Try telling a mom no when their kid has the nasty nose and fever for five days. Trust me, sometimes it is easier to give them the unnecessary antibiotics to avoid problems. Some doctors just get so used to doing it to avoid angry moms, they just do it for everybody. That is bad medicine, but unfortunately most lay people have gotten used to “getting something” for their illness. This will stop when the SHTF

Sinus: similar to colds, sinuses are probably the most unnecessarily treated condition besides cold and cough. Sinuses need washing and heat. Everyone should have a Neti Pot on their shelves for irrigation of sinuses for both infection, allergy, and exposure. Who knows what dust will be floating around WTSHTF that I don’t want in my nasal passages, so I am going to make sure I can wash ’em good. 

Throat: sore throats need salt water gargles, and monitoring. Most sore throats are viral, then second is the sore throat from post-nasal drip. Use the point scale guide for sore throat treatment that is in the antibiotics packets. 4/4 is fever, painful glands, white/gray spots on big tonsils, and no cough. Otherwise…wait for at least 24-to-48 hours even if there is a fever without the other signs. 

Chest: see the cold discussion above. Pneumonia is very rare compared to colds and bronchitis. Coughs need the same monitoring as throats basically. Regular coughs do not need antibiotics. There will be a future post about trying to decide on cough treatment with antibiotics, but for now, cough itself does not need antibiotics. 

Stomach: good luck figuring out if any stomach infection is bacterial WTSHTF. We can’t figure it out in medicine most of the time and we have labs and CT scanners and all sorts of fancy stuff. Most stomach problems like vomiting, diarrhea, and cramping are not bacterial and do not need antibiotics. Treat nausea and vomiting with fluids, fluids, and more fluids. There are some bacterial sources of gastrointestinal (GI) problems, but again it will not be feasible to really try to figure that out at TEOTWAWKI. Those with appendicitis are likely to die, similar to pioneer days. Those with diverticulitis will hopefully know the signs and symptoms of their disease and will have antibiotics on hand for that eventuality. 

Groin: I am not going to really comment on this area of infection. Protect yourself before you mess yourself to quote the kids. Prostatitis is similar to diverticulitis, those that are prone to infection should know their signs and symptoms and know what to do. 

Bladder: as previously mentioned in other posts, women know that fluids alone can treat lots of early urinary tract infections (UTIs) and should follow simple hygiene rules to help with prevention. It is estimated that at least half of all UTIs are resolved with fluids alone. 

Feet/hands: ingrown toenails and fingernails need to be drained and watched similar to other skin infections. MRSA resolves with drainage in all recent studies if early and aggressive. Drain all skin wounds before they get bigger than half-dollar sized. That’s pretty big, so pay attention when they are smaller than that please. Okay, now to go deeper. 

Veins: Most vein infections are caused by needles, so keep them out of your veins WTSHTF and you should do just fine.

Joints: Joint infections are sometimes spontaneous, but again are often caused by needles or open skin. And joint infections often take massive amounts and durations of antibiotics if bacterial to eliminate, which again will not be feasible in bad future.

There are surely things that I missed to review from head to toe, if so, comment and I can always edit this post to update any areas of failure. Most antibiotics are used unnecessarily in medicine today, so having a limited supply should not worry most people if they stop their bad overuse habits now while there is still happy future pending. – Dr. Bob

[JWR Notes: Dr. Bob is is one of the few consulting physicians in the U.S. who dispenses antibiotics for disaster preparedness as part of his normal scope of practice. His web site is: