Does Green Runny Nose = Antibiotic Rx?

runnynose2It’s a popular misconception among not just the population but also many doctors, that a greenish runny nose = bacterial infection = antibiotics. Well,  it’s not true! As this fun New York Times article reviews, the color is more a sign of clumps of  your body’s infection-fighting white cells as well as colorful shades of your normal nose bacteria. They discuss the studies that show no difference in symptoms with or without antibiotics. Here’s a quote:

According to the Centers for Disease Control and Prevention, when cold viruses infect the respiratory tract, the body makes clear mucus that helps wash away germs from the nose and sinuses. After about three days, the body’s immune cells fight back, changing the discharge to a white or yellow color. ”As the bacteria that live in the nose grow back, they may also be found in the mucus, which changes to a greenish color,” the agency says. ”This is normal.”

So, No Antibiotics. What Helps?

Since this is almost always just a viral infection and not a severe bacterial sinusitis, the best treatments are decongestants. Pseudoephedrine (sudafed) products in the Tylenol Cold/Bufferin Cold pills work well for 4-6 hours, as do the Robitussin combo syrups. There’s also the oxymetazolone (“Afrin”) nasal sprays. Also important are natural treatments including salt water nose rinses, steam, menthol rubs, and keeping well hydrated. I’m a big fan of salt water nasal rinsing — easy, effective, non-toxic and free!

By the way, even if it is “sinusitis”, there is poor evidence that antibiotics do anything more than lessen the symptoms by a day or two. Yes, in some cases it helps, especially if symptoms are severe, but in general people are overprescribed antibiotics for an infection that would go away on its own with a little TLC and time.

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2 thoughts on “Does Green Runny Nose = Antibiotic Rx?”

  1. I love my neti pot and recommend nasal irrigation all the time! No, it’s not exactly killer party conversation but good habits w/ the sinuses can go a long way toward good health.
    I am a huge believer in natural cures, and in not jumping to meds or surgery too quickly. However I must say that if things get to the “chronic” stage don’t mess around. See your doctor and then if you get a ct scan make sure you know all your options (it used to be that sinus surgery was the only option. but now there are less invasive choices like balloon sinuplasty).
    That’s my two cents. Take care everybody and keep those nasal passages clean!
    –Erin G

    1. I definitely agree that first choice for almost all sinusitis is non-antibiotic, healthy things like sinus rinses. And docs do have their role, although it is rare that anyone would even need a sinus x-ray, much less a CT and consideration of ENT surgeries. All that would be weeks down the road after trying OTC help, then failing antibiotics…

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