Thick, Greenish Runny Nose = Antibiotics? No, It Doesn't…

runnynose2It’s a popular misconception among not just the population but also many doctors, that a greenish runny nose = bacterial infection = the need to take prescription 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.
(Most of this article was originally printed in an earlier post; I am reposting some archives as I am on vacation now.)

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