The risks of taking antibiotics when you don’t need them.

As parents, we’ll do anything to help our children of all ages feel better when they’re sick. When they’re suffering from a bad cough, fever, or sore throat, it’s natural to hope that antibiotics might speed their recovery. Especially if that child is a college student — the stakes are high when they’re sick and missing class.

Many parents ask — or even demand — providers for antibiotics “just to be safe.” But research proves that taking antibiotics unnecessarily isn’t just unhelpful. On top of that, taking unnecessary antibiotics can seriously harm a person’s health.

But why not take antibiotics, just in case? Antibiotics aren’t like taking an extra vitamin — they’re powerful medications that can significantly disrupt and damage your body’s natural systems, like your immune system, digestive system, and more. Taking them unnecessarily exposes our bodies to serious risks without any benefit. Let’s break down the possibilities.

How can Unnecessary Antibiotics Harm You?

Many people believe antibiotics are harmless even if they might not help. But taking antibiotic drugs when they aren’t needed can trigger serious, sometimes long-lasting health problems. Here are five ways unnecessary antibiotics can damage your child’s health, regardless of age:

• C. difficile Infection. We take antibiotics to kill bacteria, but they also kill off normal gut bacteria, which can allow a dangerous organism called C. difficile to multiply. Taking broad-spectrum antibiotics is the most significant riskfactor for C difficile infection, which causes severe diarrhea and inflammation of the colon, sometimes lasting months and requiring extensive treatment. In fact, about 1 in 6 people who contract C. diff will get it again two to eight weeks after that, according to the CDC. This potentially deadly intestinal infection affects 500,000 Americans annually and young people taking unnecessary antibiotics are increasingly at risk of coming down with C. diff.

   

• Severe Allergic Reactions. Antibiotics are one of the most common causes of drug allergies, and reactions can become more severe with repeated exposure. What caused only mild itching during one course of antibiotics could trigger a life-threatening reaction the next time and the risk of severe allergic reaction increases with repeated exposure to the antibiotic.

• Tendon Ruptures and Joint Problems. Some antibiotics, particularly fluoroquinolones like ciprofloxacin (Cipro), can weaken the connective tissue in your body, no matter your age or fitness level. This damage can occur suddenly and without warning, sometimes long after you’ve finished taking the medication.

• Lasting Gut Microbiome Damage. Your gut contains trillions of beneficial bacteria that help digest food and protect your health. Antibiotics can devastate this delicate ecosystem, leading to long-term health problems that persist long after the medication is finished. Unfortunately, this imbalance can lead to chronic digestive problems, IBS, or other issues that can take months or years to correct.

   

• Fungal Infections. Your body maintains a careful balance between bacteria and fungi. When antibiotics eliminate protective bacteria, opportunistic fungi can quickly multiply and cause uncomfortable, recurring infections. Regardless of age or health, this imbalance can lead to oral thrush or vaginal yeast infections that can become chronic and difficult to treat.

When should you take Antibiotics?

Many parents are surprised to learn that most common illnesses don’t require antibiotics at all. While antibiotics are powerful, life-saving medications, they only work against bacterial infections — not viruses. Here are some tips to help you understand when antibiotics are truly needed and when they might cause more harm than good:

• Bacterial Infections That Need Antibiotics. Some bacterial infections absolutely require antibiotic treatment. Bacterial pneumonia can be life-threatening without proper antibiotics. Strep throat, when confirmed by testing, typically needs antibiotics. Urinary tract infections can spread to the kidneys if left untreated, and some skin infections, like cellulitis, require antibiotics to prevent dangerous spread of the infection.
• Viral Infections That Never Need Antibiotics. The common cold, flu, mono, and COVID-19 are all caused by viruses, which means antibiotics won’t help at all. In fact, about 90% of respiratory infections are viral. Giving antibiotics for these illnesses is like using weed killer on a mole infestation in your yard — it won’t solve the problem, but it will definitely cause damage.
• “Wait and See” Conditions. Many conditions, like ear infections in adults, sinus infections, and bronchitis usually resolve on their own without antibiotics. Studies show that 80% of sinus infections and most cases of bronchitis get better on their own within two weeks. For these conditions, your Pivotal Health provider might recommend watching and waiting before considering antibiotics.
• Conditions That Need Testing First. Some infections, like strep throat, can be easily confused with viral infections. That’s why testing is crucial — only about 20-30% of sore throats are actually strep infections requiring antibiotics. The only way to know for sure is through a rapid strep test.
• Symptoms That Respond Better to Other Treatments. Parents and children often report symptoms that actually respond better to other treatments instead of antibiotics. Coughs often improve with honey (in children over 1 year) and humidity. Sore throats usually respond well to pain relievers and saltwater gargles. Nasal congestion typically improves with saline sprays and humidity — not antibiotics. And college students often do not get enough sleep to support their recovery, leading to prolonged illness.

What Parents Should Know About Demanding Antibiotics

Your advocacy for your child’s health is important, but pushing for unnecessary antibiotics can backfire and damage their health. While it’s natural to want to “do something” when your child is sick, sometimes the safest action is to avoid unnecessary treatment. Antibiotics are powerful tools that come with real risks. When you’re tempted to push for antibiotics “just in case,” consider whether you might be putting your loved one at risk rather than protecting them.

Adopting a cautious approach to antibiotics means supporting your child’s recovery by encouraging them to rest, hydrate, and educating them about symptom relief through over-the-counter medications and humidifiers or vaporizers. It’s important to remember that many upper respiratory infections are viral and will resolve on their own with enough rest.

What College Students Should Know About Mono

Feeling exhausted, dealing with a sore throat that won’t go away, and fighting a fever that keeps coming back? While these symptoms might seem like mononucleosis (mono), it’s important to understand that several different illnesses can cause “mono-like” symptoms, including influenza, strep, and other viruses.

At Pivotal Health, we frequently get questions about mono from college students and their families. This guide addresses the most common questions about mono in college, including how to recognize symptoms of mono, similar illnesses, when to seek medical care, and how to manage recovery.

How common is mono in college and why do college students get mono?

The American College Health Association’s Clinical Medicine guide shows that about 1-3% of college students get mono each year, with most cases occurring during their first and second years. The peak age for mono is between 15-24 years old, according to the Centers for Disease Control.

Several factors contribute to more college students getting mono, including:

• Close living quarters in dorms and apartments
• Shared bathrooms and common spaces
• Late nights and irregular sleep schedules that can weaken immune systems
• Stress from academic and social pressures
• Common habits like sharing drinks, eating utensils, or food
• Close contact during social activities

The Epstein-Barr virus (EBV), which causes most cases of mono, spreads primarily through saliva. In college settings, this can happen through:

• Drinking from the same container
• Sharing eating utensils
• Kissing
• Close contact sports
• Exposure to coughs or sneezes in shared spaces

While anyone can get mono, understanding the unique risk factors helps explain why mono is common in college.

What are common symptoms of mono in college students?

When mono develops, symptoms often appear gradually over two to four weeks rather than hitting all at once. Early symptoms can feel like a standard cold or flu, which is why many students don’t realize they have mono right away.

Early mono symptoms:

• Increasing fatigue that doesn’t improve with rest
• Mild sore throat that gets worse
• Headaches
• Low-grade fever
• General feeling of being unwell

Common peak mono symptoms:

• Extreme fatigue that makes it hard to attend classes or study
• Severe sore throat with swollen tonsils
• Fever ranging from 101-104°F
• Swollen lymph nodes in neck and armpits
• Body aches
• Loss of appetite
• Difficulty swallowing

Other possible mono symptoms:

• Enlarged spleen (requires medical monitoring)
• Mild liver inflammation
• Rash (in some cases)
• Night sweats
• Persistent headaches

Not everyone experiences all these symptoms, and how severe they are also varies. Some college students have mild cases that seem like a cold, while others may have severe symptoms that last several weeks.

How is mono diagnosed in college students?

To diagnose mono, a skilled Pivotal Health provider will examine the college student first and determine the appropriate approach according to established medical guidelines. While symptoms can suggest mono, other illnesses like strep throat, flu, upper respiratory viruses, or COVID-19 can cause the same symptoms.

According to the Cleveland Clinic and Mayo Clinic, monospot tests can be falsely negative if they’re performed too early. The National Institutes of Health states that monospot tests produce false negative results and “peak heterophile antibody levels are seen between 2 to 6 weeks from infection.”

Testing for mono:

• Mono tests are often not effective until you’ve had symptoms for at least 10 days
• Pivotal Health’s mono test is done with a peripheral blood draw (from the fingertip or a vein)
• Testing too early leads to false negative results
• Your Pivotal Health provider will determine the best timing for testing based on your individual situation and symptom progression
• In some cases, your provider will recommend monitoring symptoms rather than immediate testing
• If your symptoms resolve before 10 days, your Pivotal Health provider might not test for mono

Diagnostic approach for mono includes:

• Complete physical exam focusing on throat, lymph nodes, and abdomen
• Thorough discussion of general health, health history, current symptoms, and recent exposures
• Medical evaluation for other possible causes of symptoms, including possible other tests for strep, influenza, or COVID-19
• Appropriate testing, including monospot test when medically indicated, at your Pivotal Health provider’s discretion

How is mono treated in college students?

Mono is caused by a virus, which means antibiotics won’t help. The most essential — and often most challenging — part of treatment for mono is rest. Many college students feel pressured to continue normal activities, but this usually backfires, leading to a longer recovery and potentially serious complications.

Rest is absolutely crucial because your body needs significant energy to fight the virus that causes mono. When college students push themselves too hard or party too hard, symptoms often worsen and lead to relapses. While recovery typically takes 2-4 weeks with proper rest, students who don’t rest often experience symptoms for several more weeks or longer. Activities like heavy exercise, going out, partying, or drinking alcohol delay recovery and can lead to serious complications.

If you have mono, your Pivotal Health provider will create a personalized treatment plan that may include:

• Guidelines for rest and activity levels
• Recommendations for managing fever and pain
• Hydration requirements
• Safe ways to manage sore throat
• Clear instructions about avoiding alcohol
• Guidelines for returning to various activities, like sports

Important mono recovery rules:

• Stay home and rest, especially during the first 1-2 weeks
• NO alcohol — it can cause serious liver complications
• NO contact sports or heavy exercise — it can rupture your spleen
• Sleep as much as your body needs
• Drink plenty of fluids
• Take medication as directed for fever and pain
• Follow your provider’s instructions exactly

Please visit an emergency room if you experience:

• Severe abdominal pain
• Difficulty breathing
• Extreme weakness

Call or text your Pivotal Health provider if your symptoms get worse instead of better, or aren’t improving after following the prescribed treatment plan, or if you have questions about returning to activities.

Recovery time can vary. College students who ignore rest requirements and continue socializing, drinking, or pushing themselves too hard typically experience much longer recovery times and may develop complications that require additional, intensive medical care.

How can college students prevent mono and know when to seek care?

Preventing mono in college means avoiding sharing drinks, utensils, or personal items; prioritizing good sleep habits; and maintaining good hand hygiene. While these prevention steps can help, mono is common in college and it isn’t always preventable.

If you develop symptoms like severe fatigue, persistent sore throat, fever, or swollen lymph nodes, especially if they last more than a few days, contact Pivotal Health. Our providers will drive to you to evaluate your symptoms and determine the best approach for treatment.

How To Manage Seasonal Affective Disorder in College

When fall and winter settle on campus, they often bring more than colder weather and finals stress. Shorter days and early darkness can make 5pm feel like midnight, leading many students to feel low on energy and down. If you’ve been feeling this way as the days get shorter, you may be experiencing Seasonal Affective Disorder (SAD), a common type of depression that follows the rhythm of the seasons.

How Does Seasonal Affective Disorder Affect College Students?

SAD is a recognized form of depression that typically starts in the fall or winter and improves as spring and summer bring longer days. Think of it as your brain reacting to the lack of sunlight — fewer daylight hours can sometimes throw off your body’s rhythm.

For college students, SAD can be especially challenging. Balancing classes, adjusting to campus life, and living away from home add layers of stress that can make it harder to manage SAD. If you moved from a sunnier, warmer place to a colder, darker location — like from Florida or California to Madison, Wisconsin — the change can feel even more abrupt and  intense. Add in the pressures of college life, and sometimes it becomes overwhelming.

The good news? There’s a strong understanding of SAD, and effective treatments are available. Recognizing SAD symptoms and finding the right resources are key steps to feeling better and making the most of your college years, even during the darkest winter months.

Who Is at Risk for Seasonal Affective Disorder?

According to the National Institute of Mental Health (NIMH), SAD affects women more frequently than men, and it’s more common in northern areas where there’s less daylight in the winter, like at UW-Madison.

SAD is often first diagnosed in young adulthood. If you’ve relocated to a place with less sunlight, it’s normal to feel confused about why you’re experiencing these feelings. But know that you’re not alone. For instance, a study in The Journal of American College Health found that “students who had moved from southern latitudes to northern New England were the most likely to experience increased depression in winter.”

What Are Common Symptoms of Seasonal Affective Disorder in College Students?

College students experiencing symptoms of SAD for the first time might be dealing with a combination of common symptoms, including:

• Feeling excessively tired or having trouble sleeping
• Losing interest in activities they normally enjoy
• Finding it hard to concentrate
• Often feeling irritated or down
• Socially withdrawing or feeling homesick and hopeless

Symptoms of SAD can range from mild to serious; effective treatment takes your personal symptoms and health history into consideration.

Effective Ways to Treat Seasonal Affective Disorder in College

Though scientists aren’t entirely sure what causes SAD, there are effective treatments. If you’re experiencing SAD symptoms, here are some options:

• Light Therapy: Using a light therapy lamp each morning for 30-45 minutes can improve symptoms. The NIMH recommends a lamp rated at least 10,000 lux.
• Vitamin D: Some students benefit from taking Vitamin D supplements, which you should discuss with your Pivotal Health provider. While research is mixed on vitamin D, some people with SAD have low vitamin D levels.
• Therapy and Counseling: Cognitive Behavioral Therapy (CBT), specifically for SAD, is designed to reduce symptoms. Your Pivotal Health clinician can connect you to options for therapy.
• Medication: If your symptoms are moderate to severe, medications that change your serotonin levels, like SSRIs, can help reduce symptoms of seasonal affective disorder. Your Pivotal Health provider can discuss options with you.

Nearly half of Americans don’t seek treatment for mental health symptoms, but reaching out can make a difference. Support and resources are available for you to feel better and succeed in college.

How to Get Help for Seasonal Affective Disorder

Are you experiencing serious symptoms of SAD? The first step is to reach out to Pivotal Health, a trusted, convenient medical provider that drives to  you to treat you in person. If you are having thoughts of self-harm, please connect with the experts at the  National Suicide Prevention Lifeline for immediate help.

Our team of licensed clinicians is here to help with depression, including SAD, and anxiety disorders. We’ll come to you, whether you’re in a dorm, apartment, or at home, and take the time to address your needs. Together, we’ll create a customized treatment plan that may include connecting you to a therapist, recommending medication, and more. We also follow up with you to make sure you’re feeling supported and on the road to feeling better.

Learn more about how we help college students with mental health care, and book an appointment through our app, website, or by phone at 888-688-4746.

Your Essential College Student Health Guide

One of the most challenging aspects of sending your child to college is worrying about their health and safety, especially when they’re far from home. That first phone call when they’re sick can be unsettling, particularly if they need urgent care.

While some college students can access convenient house calls at their dorm or apartment through Pivotal Health, all students should know how to care for themselves when ill and navigate urgent care away from home. Preparing your college student to handle common illnesses and seek appropriate care before they leave for college will boost their confidence and provide you with peace of mind.

In this article, we share tips from Pivotal Health clinicians to help parents prepare their college students for managing illnesses and seeking urgent care while away at college. These practical strategies will empower your student to make informed health decisions, ensuring they’re ready to handle medical situations independently.

What Should My College Student Know About Illnesses?

Your student may have a general understanding of common illnesses and injuries, but it’s important to talk to them specifically about how to take care of themselves and when to seek urgent care.

Discuss the symptoms of common illnesses they might get in college, such as:

• Pink eye: Redness, itching, discharge, and swelling of the eye
• Influenza: Fever, body aches, fatigue, cough, and headache
• Common cold: Runny nose, sore throat, cough, and mild fatigue
• Ear infection: Pain or discomfort inside the ear, feeling of fullness in the ear, muffled hearing, and possibly fever
• Strep throat: Severe sore throat, fever, and swollen lymph nodes
• Gastroenteritis (stomach flu): Nausea, vomiting, diarrhea, and abdominal pain
• Mononucleosis: Extreme fatigue, sore throat, fever, and swollen lymph nodes
• COVID-19: Fever, dry cough, fatigue, loss of taste or smell, and shortness of breath
• Urinary tract infection (UTI): Frequent urination, burning sensation when urinating, and pelvic pain
• Sexually Transmitted Infection (STI): Unusual discharge, pain or burning sensation during urination, sores, bumps, or rashes, itching, pain during sex
• Bronchitis: Persistent cough, chest discomfort, fatigue, and mild fever
• Meningitis: Severe headache, stiff neck, fever, and sensitivity to light
• Food poisoning: Nausea, vomiting, diarrhea, and abdominal cramps

Make sure they know about viruses and bacteria — and how antibiotics don’t work on viruses. Also, it typically takes 48 to 72 hours for people to begin to feel better while taking antibiotics. This knowledge can help them have more informed conversations with healthcare providers and understand their treatment options better.

What Self-Care Tips Should Your College Student Know When They’re Sick?

Preparing your college student to handle minor illnesses on their own is important for their health and independence. Here are some self-care tips to share with your college student:

1. Prioritize rest: Encourage your student to prioritize sleep when they’re feeling under the weather. This might mean skipping non-essential activities to get extra rest.
2. Stay hydrated: Drinking plenty of water, herbal tea, and clear broths can help fight dehydration, especially with illnesses involving fever or diarrhea.
3. Over-the-counter medications: Teach your student about appropriate use of pain relievers, decongestants, and anti-diarrheal medicines. Ensure they understand proper dosages and potential side effects.
4. Nutrition: While appetite might be low, eating small, nutritious meals can help maintain strength. Suggest easy-to-digest foods like bananas, rice, applesauce, and toast.
5. Stress management: Being sick can be stressful, especially during exams or important events. Teach relaxation techniques like deep breathing or meditation.
6. Hygiene practices: Remind them about the importance of frequent hand-washing, covering coughs and sneezes, and not sharing personal items to prevent spreading illness.
7. Create a comfort kit: Suggest keeping a “sick day” kit in their dorm or apartment with items like tissues, throat lozenges, a thermometer, and their preferred over-the-counter medications.
8. Know when to seek help: While self-care is important, make sure they understand when symptoms require professional medical attention.

Self-care tips can help them make it through minor illnesses, but you also need to educate them about when to seek medical attention, and what type of care they may need. Discuss signs that indicate a need for urgent care, such as high fevers, severe pain, or symptoms that persist or worsen over time.

What Should I Include In My College Student’s First Aid Kit?

A well-stocked medical kit can help your child manage mild illnesses or injuries on their own. Here’s a list of items to consider including:

• Bandages in various sizes
• Gauze pads and medical tape
• Antibiotic ointment
• Antiseptic wipes
• Loperamide (Imodium) for diarrhea
• Acetaminophen (Tylenol) for pain and fever
• Ibuprofen (Motrin) for pain and inflammation
• Digital thermometer
• Tweezers
• Scissors
• Hydrocortisone cream for itching
• Electrolyte rehydration mix
• Allergy medication (if needed)
• Any personal prescription medications

Make sure your child knows how to use each item in the kit and keep it in an accessible location. They should check medication expiration dates periodically and replace items as needed. This kit, combined with the knowledge of when to seek urgent care, will help your student manage minor health issues confidently while away at college.

How Can You Help Your College Student Manage Medication Refills?

Making sure that your college student can easily refill their medications will help them care for their health away from home. Here are some tips to help them with this process:

1. Choose a pharmacy near campus: Help your student find and register with a pharmacy close to their college before they leave home.
2. Set up mail-order prescriptions: For maintenance medications, consider setting up a mail-order service that can deliver refills directly to your student’s campus address.
3. Use smartphone apps: Many pharmacies offer apps that make it easy to request refills and receive notifications when medications are ready.
4. Understand prescription insurance coverage: Review your insurance plan’s policies on out-of-network pharmacies and teach your student how to use their insurance card.
5. Keep track of refill dates: Encourage your student to set reminders for when they need to request refills, allowing enough time for processing.
6. Have a backup plan: Ensure your student knows what to do if they run out of medication unexpectedly, such as how to connect with their doctor or reaching out to Pivotal Health for an emergency refill.

What Health Information Should Your College Student Know Before Leaving Home?

Before your child leaves for college, discuss their medical history, family health background, and potential health risks. Ensure they know their own medical history, including allergies, chronic conditions, and current medications. Help them to manage ongoing health issues like asthma or diabetes independently with necessary supplies on hand.

Don’t forget to mention significant health issues that run in the family. Some illnesses may first appear in young adulthood, so awareness of family health risks is important. This conversation empowers your college student to be an informed advocate for their own health.

How Do You Find Urgent Care For Your College Student?

Before your child leaves for college, take time to research urgent care and emergency care options. You may have a choice of university-run health services and urgent care clinics, however, consider more accessible alternatives like Pivotal Health, which has several important benefits for college students, such as extended evening and weekend hours, priority appointment scheduling for members, and the convenience of house calls.

Pivotal Health’s membership-based service offers unlimited urgent care house call visits with a unique advantage: licensed providers drive directly to your student, even in their dorm room or apartment. Parents with high-deductible health plans (HDHP) will especially appreciate Pivotal Health’s cost-effective membership model, which can help manage healthcare expenses.

Pivotal Health’s house calls eliminate the stress of navigating an unfamiliar city while feeling unwell. College students particularly appreciate scheduling urgent care house calls with the Pivotal Health app, booking clinicians for urgent care, primary care, and mental health services, all in the comfort of your student’s living space. This approach ensures your child can receive professional medical attention without the hassle of travel or waiting rooms.

Encourage Your College Student to Seek Urgent Care When Needed

Perhaps the most important tip is to encourage your child to seek help when they need it. Many college students hesitate to get medical attention, worried about costs or missing classes. Reassure your child that their health and well-being should always be the top priority, and that seeking prompt care can prevent minor issues from becoming major problems.

By equipping your student with knowledge about treating common illnesses, and convenient urgent care options like Pivotal Health, you’re setting them up for success. This preparation helps them stay healthy and builds their confidence to manage their own healthcare. With the right guidance, you can feel more at ease knowing your child is ready to handle health challenges while away at college.

Anxiety disorders are the most prevalent behavioral health concern in the United States, affecting around 20% of the adult population.

What are anxiety disorders?
Everyone feels anxious sometimes; anxiety is a normal reaction in many situations. However, if feelings of anxiety are extreme and/or chronic, they can rise to the level of an anxiety disorder.

What does an anxiety disorder feel like?
Anxiety disorders can have many physical symptoms, including:

• Rapid heart rate or breathing
• Trouble focusing on anything other than intense worry
• Difficulty sleeping
• Feeling tense or nervous
• Avoiding certain locations or situations that provoke worry
• Headaches or gastrointestinal symptoms (stomachache, diarrhea)
• Irritability
• Fatigue
• Muscle tightness

What are some strategies to manage anxiety?

• Exercise regularly
• Create healthy sleep habits and get enough sleep
• Practice relaxation techniques like mindfulness meditation
• Learn and practice breathing techniques for anxiety
• Reach out and connect to those in your support system

When do you need medical care for a suspected anxiety disorder?

Reach out to a provider if:

• Your anxiety is interfering with your daily activities
• Your feelings of worry, fear, and anxiety feel out of control
• You are also struggling with feelings of depression or other behavioral health symptoms
• You find yourself relying on alcohol or other substances to reduce your anxiety
• Your anxiety is causing physical symptoms such as headaches or stomachaches
• You think you might harm yourself or others
• If you feel you are a danger to yourself or others, seek emergency care immediately.

Get Help from Pivotal Health
If you’re struggling with anxiety, Pivotal Health can help. Schedule an appointment in the Pivotal Health app or contact our triage support team at 888-688-4746 to arrange for one of our licensed providers to come and speak with you in the privacy and comfort of your own home, on your own schedule. Pivotal Health clinicians are specially trained to assess and diagnose anxiety disorders and other behavioral health conditions. We then can recommend an individual treatment plan that might include a therapist and/or medications, depending on your situation.

All Pivotal Health clinician visits, including those to assess and treat anxiety disorders, include follow-up consultation, leading to a calmer, healthier path forward.