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Amoxicillin for cough and cold symptoms: What experts say

Antibiotics like amoxicillin can cause more harm than good when misused
Rosemary Black
By | Nov. 21, 2024 Medically reviewed by Anne Jacobson, MD, MPH
An antibiotic capsule: Amoxicillin for cough and cold symptoms

Key takeaways

  • Amoxicillin is an antibiotic that is effective at treating bacterial infections, but it should not be prescribed for a viral infection.

  • Most coughs caused by colds or by the flu will not respond to amoxicillin.

  • A high fever for more than three days and a bad cough that lasts for three weeks may mean that you have a bacterial infection.

  • Some people, such as those who have cancer, immune problems, or take steroids, may be more prone to bacterial infections and should seek medical attention sooner.

  • Amoxicillin can have side effects such as nausea or diarrhea. More serious side effects, such as a severe rash or difficulty breathing, should prompt you to seek emergency care.

In this article:

Amoxicillin is a generic antibiotic that can treat many infections caused by bacteria, such as pneumonia, bacterial bronchitis, urinary tract infections, and ear infections. Like other antibiotics, amoxicillin is not effective for treating viral infections like colds and the flu. But since coughing can be a symptom of various bacterial infections, such as bacterial bronchitis and pneumonia, you may wonder whether amoxicillin can help shorten the duration and severity of your cough. The answer isn’t so straightforward, and taking antibiotics when you don’t need them can do more harm than good.

Can you take amoxicillin for cough and cold symptoms?

Amoxicillin may help a cough caused by a bacterial infection, but most coughs are caused by viral infections. And amoxicillin won’t help a cough caused by a virus. 

“Most coughs that occur during the cold and flu season are caused by viral infections,” says Sean Ormond, MD, of Atlas Pain Specialists in Glendale, Arizona. “Bacterial infections are much less common.” 

Coughs have many causes, and not all are caused by infections. “A cough with a runny nose could be due to allergies in the environment from something you are allergic to, such as pollen,” says Dmitry Volfson, DO, chief medical officer at CityMD Urgent Care in New York City. If your cough is due to allergies, amoxicillin or another antibiotic will not help.

If your cough is due to a bacterial infection, amoxicillin may be helpful in clearing the infection, but some research proves otherwise. Research published in The Lancet in 2013 found that amoxicillin offered little benefit for many respiratory tract infections and may even worsen the symptoms. Another study, which was discussed in an American Family Physician review, found that 1 in 8 people who took a form of amoxicillin for acute bronchitis experienced adverse effects. 

Another large study in primary and urgent care settings in the United States found that people had unrealistic expectations that taking an antibiotic would shorten their illness. But in reality, antibiotics had no impact on how bad their cough was or how long it lasted.

The problem with taking antibiotics for coughs

When we take antibiotics unnecessarily or misuse them, we threaten their effectiveness. Taking an antibiotic like amoxicillin when it isn’t needed may cause antimicrobial resistance, which happens when germs like bacteria develop the ability to defeat the antibiotics designed to kill them. As a result, the antibiotics that would otherwise treat them become ineffective.   

Many kinds of bacteria have developed a resistance to amoxicillin. This antibiotic’s mechanism of action depends on a part of the drug’s structure called the beta-lactam ring. When bacteria become resistant to amoxicillin, they produce enzymes called beta-lactamases that break apart the beta-lactam ring, which means the drug doesn’t work. Because of this, amoxicillin is now usually given along with clavulanate, a beta-lactamase inhibitor that helps amoxicillin kill the resistant and the susceptible bacteria. Typically, these two drugs are combined into a single drug, amoxicillin-clavulanate (Augmentin). But taking amoxicillin-clavulanate is also a risk factor for having other kinds of antibiotic-resistant infections in the future. 

“Not only can taking an antibiotic to treat a viral infection contribute to antibiotic resistance, but it also can disrupt the balance of good bacteria in your body, which can lead to issues like digestive disturbances and yeast infections,” Dr. Ormond says.

How to know whether you need antibiotics to treat your cough

It can be difficult to determine whether you need antibiotics to treat your cough since coughs have a variety of causes, and the cause determines the best course of treatment. It is important to communicate all of your symptoms and a timeline of when they started with your healthcare provider, who will determine the best course of treatment. 

Your healthcare provider may suggest watchful waiting before prescribing an antibiotic. “Unless you have a compromised immune system or another medical condition, it is okay to just monitor your symptoms for two or three days,” Dr. Volfson says. “If your symptoms are getting worse, or you have a fever that is not going down, and you feel really lousy for more than a couple of days, you should go to the doctor.”

If your cough is caused by bronchitis, you may also experience tiredness, wheezing, and a low fever. Acute bronchitis can clear up on its own within two to three weeks. Chronic bronchitis, which occurs in people who have chronic obstructive pulmonary disease (COPD), can last for months. Treatment for bronchitis may include home remedies (like gargling with salt water and using a humidifier), NSAIDs (like ibuprofen and naproxen), bronchodilators (like Ventolin, Alupent, Xopenex, and Maxair), an expectorant like Mucinex, cough suppressants (dextromethorphan), and antihistamines (like Zyrtec or Claritin). 

Antibiotics like amoxicillin may be prescribed for bronchitis if a healthcare provider believes the case of bronchitis is caused by a severe bacterial infection that isn’t clearing up with other methods. Daniel B. Levy, MD, of Mercy Personal Physicians at Lutherville in Lutherville, Maryland says that people with bronchitis won’t benefit from an antibiotic in many cases. Exceptions include people who have a compromised immune system, are taking steroids, or are in chemotherapy.

Pneumonia is a lung infection that can cause coughing and breathing difficulties and feel like a bad case of the flu. It can be caused by bacteria or by a virus. “Signs that the infection may be bacterial include a cough that lasts for three weeks, a fever that doesn’t go away after a few days, difficulty breathing, and chest pain,” Dr. Ormond says. If your healthcare provider suspects pneumonia, they may recommend over-the-counter pain relievers like ibuprofen and acetaminophen, cough medicines, plenty of liquids, and lots of rest. Dr. Levy says that although someone with pneumonia is likely to be prescribed an antibiotic, the antibiotic won’t help if the pneumonia is viral. “It is not always obvious that pneumonia is viral,” he adds.

“Your doctor can perform the necessary evaluations and tests to determine the cause of your symptoms,” Dr. Ormond says. 

Amoxicillin dosage for respiratory infections

Amoxicillin is available as a tablet, capsule, chewable tablet, and a suspension (liquid) to take by mouth. Amoxicillin dosage depends on the type of infection being treated, the severity, and the age of the patient. For example, the standard dosage of amoxicillin for community-acquired pneumonia in adults is 1 gram every eight hours for at least five days. “If you are prescribed antibiotics for a bacterial infection, be sure to finish all the medicine,” Dr. Volfson says. “If you take it for a few days and then stop, the bacteria causing the infection get a little tricky, and they get smarter. And over time, there could be an outbreak of illness that won’t be helped by the antibiotic since the bacteria can have become resistant.”

Amoxicillin side effects

As with any medication, amoxicillin can have side effects. “The most common ones are nausea and diarrhea,” says Alyssa M. Wozniak, Pharm.D., BCPS, assistant dean for clinical affairs, outreach, and special projects in the School of Pharmacy at D’Youville University in Buffalo, New York. More serious side effects are also possible, such as itching, hives, wheezing, difficulty swallowing or breathing, prolonged vomiting, a severe rash, and swelling of the face, tongue, lips, eyes, and throat. If any serious side effects occur, stop taking the amoxicillin and seek medical attention.

Who should not take amoxicillin for cough

Dr. Wozniak says you should not take amoxicillin for a cough or for any other reason if you have had a serious allergic reaction to amoxicillin or a similar antibiotic like penicillin. Amoxicillin may interact with certain medications. “Be sure to tell your doctor about any past severe reactions to antibiotics so they can find a safer option for you,” she says.