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Green phlegm and snot ‘not always a sign of an infection needing antibiotics’

Besi Besemar November 18, 2013

Public Health EnglandHaving green phlegm or snot is not always a sign of a bacterial infection that will require antibiotics to get better, says Public Health England (PHE) and the Royal College of General Practitioners (RCGP).

This advice is issued on European Antibiotics Awareness Day (November 18) which aims to raise awareness of the risks associated with the inappropriate use of antibiotics and how to use them responsibly.

Research by PHE’s Primary Care Unit has found that forty per cent of the general public believed that antibiotics would help a cough with green phlegm get better more quickly rather than clear phlegm (six per cent).

White blood cells are produced by the body to attack any foreign materials the body does not recognise such as pollutants, dirt, pollen or microbes, and are carried in your phlegm and snot.  Some white blood cells contain a green substance (a protein) so if more of these cells are present the greener your phlegm or snot will be.

Phlegm therefore comes in a range of colours from white to mustard-yellow to varying shades of green. Coloured phlegm or snot does not mean you need antibiotics.

In most healthy people, phlegm or snot production with or without a cough will stop as your cold or flu-like illness clears up, although it may take up to three to four  weeks.

Cliodna McNulty
Cliodna McNulty

Dr Cliodna McNulty, head of PHE’s primary care unit said: “It’s a prevailing myth that anyone with green phlegm or snot needs a course of antibiotics to get better. Most of the infections that generate lots of phlegm and snot are viral illnesses and will get better on their own although you can expect to feel pretty poorly for a few weeks. There are plenty of over-the-counter medicines which are very effective in managing the symptoms of these illnesses and can reduce headache, muscle soreness, fever and sore throats.

“The problems of antibiotic resistance are growing. Everyone can help by not using antibiotics for the treatment of uncomplicated infections. Any antibiotics we take will also kill many of our normal bacterial flora in the gut. Antibiotics also encourage other bacteria in our gut to develop resistance to antibiotics by changing their genetic makeup. These resistant bacteria can then in turn pass their resistance genes on to other bacteria, or they can be passed to other people we have close contact with. In the long run, this will mean our antibiotics become less effective, or in the worse case scenario, not effective at all.

“Many people have a good understanding of what antibiotic resistance is but when it comes to their own illnesses still believe that antibiotics can help to treat what can be severe cold and flu symptoms. This is not the case and we must get away from believing this to preserve these precious medicines for when we really need them.”

Maureen Baker
Maureen Baker

Dr Maureen Baker, Chair of the RCGP, said: “The statistics from Public Health England are not surprising. Many patients expect their GPs to prescribe antibiotics, even for cases that will get better naturally or respond better to other treatments.

“This guidance will go a long way to bust the myths surrounding antibiotics and promote more effective alternatives, which can often be easily managed by patients.

“Overuse of antibiotics is a serious public health concern and a clinical priority for the RCGP. Infections adapt to antibiotics used to kill them and can ultimately make treatment ineffective so it’s crucial that antibiotics are used appropriately. That’s why we have recently updated our comprehensive TARGET toolkit, developed in collaboration with PHE, to include new guidance for GPs and their patients on the appropriate prescription of antibiotics so that they do not build up an immunity for the future when they might really need them.”    

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