Adults with acute cough/lower respiratory tract infection who present with discolored sputum appear to be prescribed antibiotics more often than those with clear/white sputum, according to a recent study; however, antibiotic prescribing was not associated with recovery or benefit.

Researchers of a large international study consisting of more than 3,400 patients in 13 countries investigated whether discolored sputum and feeling unwell are associated with antibiotic prescribing and whether there are benefits from antibiotic treatment for acute cough/lower respiratory tract infection.

Patients with yellow or green sputum were prescribed antibiotics more than three times as frequently as those who had clear or white sputum. Antibiotic prescribing were not associated with a greater rate or magnitude of symptoms score resolution.

Patients with yellow or green sputum feeling mildly unwell reported initial symptom scores of 23.3 out of 100 (patients not prescribed antibiotics) and 21.3 (patients prescribed antibiotics). After 7 days, those not taking antibiotics recorded an average symptom score of 4.3, compared with 3.9 in those taking antibiotics.

The color of sputum appears to be commonly misinterpreted by both physicians and doctors to mean that antibiotics are needed.  In a time when there is an alarming increase in resistance of bacteria that cause community-acquired infections, the overuse and misuse of antibiotics continues to be a public health concern.