Do I Need Antibiotics When Hacking Up Discolored Sputum?

You’re hacking up a lung and coworkers won’t come within 5 feet of you without a mask and a pump sprayer of Lysol.

Worse, you’re now coughing up sputum that has become the color of something out of the Exorcist.  It’s no longer time to mess around-you need antibiotics.  Stat.

I can’t tell you how many times I have heard this statement.  Somehow, when your sputum gets some type of yellow or greenish color to it, you think it’s a sign of something sinister that’s going to need antibiotics.  Something you need to understand first–sputum is essentially sterile.  It is the end result of your white blood cells attacking and destroying an invader.  The color is usually a result of dead cells of the airway as well as inflammatory cells.  While bacteria can be present in the sputum, this is not always the case.

All of this brings me to this particular study.  In it, researchers looked at the effect of the use of either anti-inflammatories (600 mg ibuprofen 3x / day), antibiotics (amoxicillin-clavulanic acid 500 mg/125 mg 3x / day) or a placebo had on the time it took to resolve an infection that included discolored sputum.  The results may surprise you.  Here’s what the researchers found:

  1. The number of days with frequent cough was slightly lower among patients assigned to ibuprofen (9 days compared to 11 days with antibiotics and placebo)
  2. Neither antibiotics nor ibuprofen increased cough resolution compared with placebo.
  3. Side effects were most common in the antibiotic group (12%) than ibuprofen (5%) or placebo (3%).

Overall, this should blow the myth that discolored sputum is a sign that it is time to run to the doctor and get on antibiotics.  Regular readers of the Rantings should have a very good idea of how much this single course of, arguably uneeded, antibiotics will destroy the healthy balance of the bacteria in your gut.

Instead, opt for immune boosting activities like light exercise, vitamin D and A (although hopefully, you have already been taking these and did not get sick in the first place), no refined carbs and high doses of vitamin C (8-10 grams per day).  The healthy bacteria in your gut and the balance they confer to your immune system will thank you.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.