Viral upper respiratory tract infection and the common cold — branching viva

Branch 1 — The meaning of purulent discharge

The discharge has turned green. The parent says "this is infected, he needs an antibiotic." The opening question asks whether the colour change indicates bacterial infection, and the probes explore the mechanism behind the colour change (neutrophil myeloperoxidase staining sloughed epithelial cells and inflammatory debris), the Cochrane conclusion on antibiotics for the common cold and acute purulent rhinitis (no benefit, no shortening of illness, no prevention of complications, with added side effects and resistance), and how to explain this to a parent without dismissing their concern. ^{[1] [4]}