A chest infection of the airways, not the lung tissue. Usually viral — and the cough outlasts what most people expect.
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Acute bronchitis is inflammation of the airways — the tubes carrying air into your lungs — usually following a cold or another virus. It is not pneumonia, which affects the lung tissue itself, and the distinction matters because bronchitis rarely makes you seriously unwell while pneumonia can.
The most useful fact on this page is about how long it lasts. Most people expect a chest infection to clear in five to seven days. The actual median duration of the cough is around three weeks, and it is entirely normal for it to run to four. Almost every request for antibiotics for a chest infection comes from that gap between expectation and reality — not from anything having gone wrong.
The second thing worth knowing: green or yellow phlegm does not mean you need antibiotics. The colour comes from immune cells doing their job, and it happens in viral infections just as readily as bacterial ones. It is one of the most persistent misunderstandings in medicine, and it drives a great deal of unnecessary prescribing.
Around nine in ten cases are viral, and in an otherwise healthy adult antibiotics make almost no difference to how long the cough lasts.
You should feel gradually better, not worse. Getting better and then deteriorating again — fresh fever, worsening breathlessness, sharp chest pain on breathing in — suggests pneumonia has developed, and needs assessment.
A cough producing phlegm on most days for at least three months, in two consecutive years, is chronic bronchitis — and in practice that is part of COPD rather than a repeated infection.
If that describes you, the answer is not more antibiotics. It is breathing tests, a proper COPD assessment, and help with stopping smoking. This is a common and consequential thing to get wrong.
An acute cough following a viral illness, in someone who is not seriously unwell, is acute bronchitis. No test confirms it and none is needed in a straightforward case.
What matters is excluding pneumonia — and the things that point away from simple bronchitis are a high fever, real breathlessness, pleuritic chest pain, a fast breathing rate, and feeling profoundly ill rather than just fed up with coughing.
This is well suited to a remote consultation — the diagnosis rests on the history, and the main task is deciding whether it is simple bronchitis or something that needs more.
If the assessment points to pneumonia, we will say so and direct you to same-day face-to-face care. That needs a chest listened to, which we cannot do.
Knowing that three weeks of coughing is normal removes most of the worry, and most of the pressure to take something that will not help. The trajectory matters more than the duration: slowly improving is fine, getting worse is not.
For a straightforward cough in a healthy adult in week one, you do not need to pay anyone. Honey, fluids, patience, and knowing the red flags is genuinely the whole of it.
We will tell you when antibiotics are not indicated. Paying for a consultation does not buy a prescription, and we would rather be straight about that up front.
This page follows NICE guideline NG120 on acute cough associated with an upper respiratory tract infection, NICE NG117 on antimicrobial prescribing for acute cough, NICE NG12 on suspected cancer referral, and NICE Clinical Knowledge Summaries.
A productive cough on most days for at least 3 months in each of 2 consecutive years defines chronic bronchitis, which is a feature of COPD and warrants spirometry and structured assessment rather than repeated courses of antibiotics.
Reviewed against NICE NG120, NG117, NG12 and NICE CKS guidance current at the date shown above.
No, and this is the most common misunderstanding about chest infections. Green and yellow colour comes from immune cells breaking down, and it happens just as much with viruses.
Sputum colour alone should not drive antibiotic prescribing, and NICE says so explicitly.
Because three weeks is normal. The median duration of an acute bronchitis cough is around three weeks, and up to four is unremarkable.
What matters is the direction, not the duration — slowly improving is fine; getting worse is not.
In a healthy adult, they shorten things by well under a day on average. In exchange you get a meaningful chance of diarrhoea, thrush or a rash.
They are worth it if you have COPD, are immunosuppressed, are frail, or are genuinely very unwell — and we will prescribe readily in those situations.
A prescription you hold and only use if you get worse over the next few days, rather than starting it straight away.
NICE supports this approach, and it works well when the picture is borderline or you are heading somewhere without easy access to care.
The pattern to watch for is improving and then deteriorating — fresh fever, new breathlessness, or sharp chest pain when you breathe in.
Feeling seriously ill rather than just sick of coughing is the distinction, and it needs same-day face-to-face assessment.
Honey has the best evidence of anything you can buy, and NICE recommends it. Never give it to a baby under one year old.
Fluids, rest and sleeping propped up help too. Most cough mixtures do very little.
No, and it deserves proper investigation. Recurrent chest infections may point to undiagnosed asthma, COPD, bronchiectasis or reflux.
The answer is breathing tests and an assessment, not another course of antibiotics.
Consider it if you have severe coughing bouts, vomit after coughing, or struggle to catch your breath between coughs — particularly beyond two weeks.
It is frequently missed in adults, and it matters a great deal if you are pregnant or around young babies.
If it is most days for three months, two years running, that is chronic bronchitis — which is COPD, not a series of infections.
You need spirometry and a proper assessment, and support with stopping smoking if you smoke.
If you feel up to it and are not feverish, yes — you are most infectious in the first few days, and the cough outlasts the infectious period considerably.
Stay away if you are feverish, or if you work with people who are vulnerable, and we can issue a sick note if you need one.
August 30, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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