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It is a widespread belief that antibiotics should not be used for treating viral infections, as they are effective against bacteria, not viruses (see e.g. http://www.cdc.gov/features/getsmart/). Several studies have been made supporting this claim, for instance this 1984 study and newer 2014 review.

However, antibiotics continue to be prescribed, mostly due to patient demand, and also because of fear of complications (FoxNews article). In case of respiratory viral infections secondary bacterial pneumonia is often mentioned as a cause of concern and a reason for antibiotics prescription (2006 study).

Also, this article states that

Around one person in 20 with bronchitis may develop a secondary infection in the lungs leading to pneumonia. The infection is commonly bacterial although the initial infection that caused the bronchitis may be viral.

Some studies also say that certain classes of antibiotics (e.g. macrolides) have positive anti-inflammatory and immunomodulatory effects (2012 study).

What I'm confused about is this: in case when there are no secondary bacterial infection symptoms, is antibiotics usage justified? Does the risk of secondary infection outweigh the negative effects of antibiotics?

  • While I've made minor edits to your question, it has some problems I can't solve. The question in the title ("Are antibiotics effective for treatment of respiratory viral infections?") could work here, but you already give an answer in the body. The question in the body ("Is this then reasonable to state that fear of complications alone (without relevant symptoms) justifies the use of antibiotics for viral infections treatment?") is asking for opinions and not evidence. – Sklivvz Feb 2 '16 at 10:47
  • @Sklivvz - thank you for edits and comment! Do you meat that the answer already given in the body is the fear of complications being an enough justification? I'll attempt at rewording the question so that it's more evidence-based. – siphiuel Feb 2 '16 at 10:52
  • No, the answer given in the body is that antibiotics "are effective against bacteria, not viruses" and "secondary bacterial pneumonia is often mentioned as a cause of concern and a reason for antibiotics prescription". The opinion based part is when you ask whether this is "reasonable". We can't possibly answer that... – Sklivvz Feb 2 '16 at 10:55
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    It's one of those things that would often be a case-by-case judgement call by a doctor. For example I think antibiotics might be prescribed if someone was at particularly high risk of pneumonia (e.g. age, or weakened immune system e.g. post-surgery). Maybe it's better on a medical site (health.stackexchange.com probably) where a doctor could say "I'd make this call based on X, Y and Z factors". I think all we can do here is confirm there's a genuine case for, and a genuine case against - which you've already done. – user56reinstatemonica8 Feb 2 '16 at 11:00
  • Thanks for comment. I've reworded my question slightly, hopefully it is better now. Otherwise i'm also inclined to think that this a judgement call to be decided on a case-by-case basis. – siphiuel Feb 2 '16 at 11:04