Q: I understand that doctors are supposed to be trying to reduce the use of antibiotics. Is it easy to determine who should receive them and who should not?
Related: Are those antibiotics doing you any good?
A: The short answer is no; it is a big subject but the biggest problem centres around infections of the chest, nose and throat, common winter infections in humans. Bacterial infections will respond well to antibiotics, viruses will not.
Sore throats can be caused by either but the majority are viral, a definite opportunity to wait a week and not trouble your GP.
Similarly anything that starts with symptoms of a head cold is also likely to be viral and best left untreated with antibiotics.
More problematic are those infections that affect the chest. Some of these may start as viral infections but the damaged chest can develop a secondary infection, often bacterial. A typical example would be the chest infections and pneumonias which follow flu outbreaks.
Interestingly the outcome of an episode of bronchitis (which affects just the upper branches of the airways), whether caused by bacteria or viruses and regardless of the colour of the sputum produced, is not affected by whether you take antibiotics, the important caveat being that you must be in good health otherwise. Over the years doctors have commonly treated these, and patients have come to expect treatment for them. Another opportunity not to!
Chest infections where abnormalities deeper in the lung are identified with a stethoscope or a chest X ray should always be treated with antibiotics. Some of them are due to viruses but the risks of an infection like this, which is technically a pneumonia, is so much greater that antibiotics are used to ensure that a life-threatening bacterial infection is not missed.
Diseases, sadly, do not always follow convention, so if your apparently simple virus infection relentlessly deteriorates or is associated with unusual symptoms then you should check with your GP, but do not necessarily expect antibiotics.