Antibiotics, bronchitis, sinusitis and the common cold

I am a simple family doctor. But I lay claim to being a specialist in warts, sore throats, colds and flu. Everyday, all year long I see patients with congestion, sore throat, sinus pain, chest congestion and cough. I know the common cold.
Many people think they know the common cold. Runny nose, sore throat, cough and congestion that goes away in 3 or 4 days right? Not quite. Although many colds do run their course in just a few days, the majority that I see last 1, 2 or even 3 weeks. It is still a common cold even after 2 weeks.
The medical profession is inconsistent in this regard. Although we all know the dangers and the uselessness of antibiotics for colds, we continue to prescribe. But, we change the illness. We diagnose sinusitis, bronchitis and otitis. Daily I will see a patient who says, "I just wanted to be sure I wasn't getting sinusitis or bronchitis." The fact, you do have sinusitis and bronchitis! The definition of sinusitis is inflammation of sinuses, bronchitis is inflammation of the bronchioles. This happens with almost every cold.
When then do you need antibiotics for sinusitis and bronchitis? Rarely. If you are in day 3-5 of an illness, the sinuses will be full and you will have pressure. This is the normal course for a virus. If you are day 14 and you are developing a new fever, you have sinus pressure on one side you may need an antibiotic. Bronchitis? There is no indication for an antibiotic. If you have cough, fever and on exam you have lower respiratory findings and on xray you have markings, you have pneumonia need an antibiotic.
Overuse of antibiotics has led to MRSA, VRE, C. diff and other bacteria that can not be treated by usual antibiotics. Antibiotics cost you money and give you diarrhea. If your doctor tells you to treat your cold with Tylenol and rest, thank him or her, skip the pharmacy and go right back home to bed!