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Dr. Jennifer Nelson, with Roper St. Francis Express Care on Ladson Road, checks a patient's flu test in December 2016. The test came back negative for the flu. Roper St. Francis doctors say it is common for patients to demand or expect antibiotics, especially during the holidays. File/Brad Nettles/staff

Every year during the holidays, Roper St. Francis physicians Dr. Valerie Scott and Dr. Todd Detar have to tell some of their patients "no."

Many people don't want to be sick when they come down with a cold. Often traveling to visit family and friends or dealing with the stresses of hosting, people want a quick fix to their maladies. So, they ask for antibiotics.

"It’s pretty frustrating from our standpoint," Detar, who practices at Roper's Express Care clinics, said.

Doctors are being educated to avoid prescribing antibiotics when possible. Because of overuse of the drugs, some bacteria are learning to be resistant to the medications. The resulting "superbugs" kill hundreds of Americans every year.

But this can be a particularly hard message to explain to patients who are looking for symptom relief during the height of flu season. New numbers published by the S.C. Department of Health an Environmental Control on Wednesday show that 15 South Carolinians have died from the flu so far this season. Flu activity across the state continues to be widespread and, so far this season, more than 800 people have been hospitalized in South Carolina. 

But antibiotics don't kill the flu, which is caused by a virus, not bacteria. 

Meanwhile, bacterial infections resistant to antibiotics make about 2 million Americans sick every year and kill about 23,000, according to Pew Charitable Trusts. That amounts to $26 billion and 8 million additional days spent in a hospital each year.

It has sparked a public health effort to convince doctors not to prescribe antibiotics when they are not necessary and has taught some patients not to ask for them.

Antibiotic use decreased by 20 percent in Columbia, 16 percent in Charleston and 12 percent in Greenville between 2010 and 2016, according to a recent Health of America report, which was published by the Blue Cross Blue Shield Association. Those rates represent an even greater drop than the U.S. average, which was 9 percent.

Most common-colds cannot be cured with antibiotics, a message doctors have increasingly been sending to their patients. But that doesn't stop some people from continuing to ask for them, and rewarding doctors with poor online reviews if they do not get the antibiotics they feel they need, the doctors said.

Ninety-eight percent of sinus infections are viral, Scott, a primary care physician at Mount Pleasant Family Practice, said. Antibiotics are no good for viral infections. 

She said many people come in to her office worried about bronchitis. Scott said to think of the possibility of bronchitis as a simple chest cold that will most likely not turn into pneumonia. 

Antibiotics are now known to kill healthy bacteria in your gut, which is damaging to your microbiome, a growing amount of research has found.

The Roper doctors said they want their patients to be happy and they know people don't want to hear that a combination of bed rest, saline and over-the-counter medications is their best bet. But Scott also said people should view antibiotics more like chemotherapy — it can be damaging to the body and you wouldn't want to put your system through it too often.

"There is a lot of harm that can happen," Detar said.

Reach Mary Katherine Wildeman at 843-937-5594. Follow her on Twitter @mkwildeman.