PROVE IT
Green can mean no antibiotics
October 10, 2009
The Claim:
With a runny nose, green calls for an antibiotic.
THE FACTS:
Old prescription habits apparently die hard.
Studies suggest that most doctors say they would prescribe an antibiotic if a child with sinus symptoms also had green nasal discharge. The habit stems from the notion that green indicates a bacterial infection. But green is no more common in a bacterial infection than a viral one, for which antibiotics are ineffective.
In a definitive study from 1984, scientists put 142 children with green nasal discharge into groups, including one that was treated with antibiotics and another that received a placebo. The drugs had no effect on "potentially pathogenic organisms" or on symptoms. About 35 per cent of subjects treated with antibiotics showed improvement, compared with 31 per cent in the placebo group. More recent studies have bolstered that conclusion.
According to the U.S. 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 colour. "As the bacteria that live in the nose grow back, they may also be found in the mucus, which changes to a greenish colour," the agency says. "This is normal."
The only time antibiotics are needed for a runny nose, experts say, is when the diagnosis is bacterial sinusitis.
THE BOTTOM LINE:
The colour of nasal discharge should not dictate the medicine.
The New York Times
Toronto Star