The colours of phlegm

How are you with phlegm? Is it a difficult moment for you when you have a cold or flu and open the tissue to check what colour you have just coughed up? Perhaps you might have retained that six-year old enthusiasm for your various bodily excretions but whatever your attitude to it, there is a perception that the colour of your phlegm tells you something about the depth and nature of your illness. While that is true to an extent, new research suggests that even when phlegm is green antibiotics won’t help.

Phlegm is mucus that has been coughed up from your lungs. It results from inflammation so that is one thing for sure that your phlegm tells you. Clear or cloudy phlegm tells you that you have a viral infection. If the mucus is yellow then you have an active infection (probably viral) and the phlegm contains immune cells called leukocytes. If your phlegm is green then the belief has been that it contains pus, immune cells mixed with bacteria. For this reason green phlegm has been regarded as a sign that antibiotics are called for. The latest study though, casts doubt on this.

The research included 3400 patients who presented to medical centres with acute cough. The researchers found that people with yellow and green phlegm were prescribed antibiotics more often than those with clear phlegm. However, antibiotic use did not lead to more rapid resolution of symptoms in people with coloured phlegm.

So benefits from antibiotic use for people with yellow or green phlegm was, according to the researchers, marginal at best and mostly non-existent.

What we can say about phlegm then, is that when it is yellow or green it indicates that an infection is active but that the infection may still be viral and of course, antibiotics are only useful against bacteria, not viruses.

Given the problems these days with antibiotic resistance resulting from overuse, the lesson here is not to think that antibiotics are necessary just because your phlegm is yellow or green. Rather than pressuring your health practitioner for antibiotics, take a more phlegmatic approach, and leave it to them to look for other indications that a bacterial infection exists.

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