Most are viral and need no antibiotic. Knowing which are not is the point of the consultation.
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"Chest infection" covers two quite different illnesses, and the distinction decides whether antibiotics help.
Two things are worth knowing before anything else.
The cough lasts far longer than anyone expects. The average cough after a chest infection is around three weeks, and six to eight is not unusual — even when the infection has completely gone. Not knowing this is why people take a second and third course of antibiotics for a cough that was always going to take that long.
And green phlegm does not mean you need antibiotics. The colour comes from your own immune cells, not from bacteria. It is one of the most persistent misunderstandings in general practice.
We should be clear about our limits: we cannot listen to your chest or measure your oxygen levels by video. Where that matters, we will say so and arrange for you to be seen.
Because the infection damages the lining of the airways, and it takes weeks to repair. During that time the airways are hypersensitive, so cold air, exercise, laughing or a deep breath set off coughing. This is healing, not persisting infection, and it is not a reason for more antibiotics.
Much of this is done from the history, and a video consultation covers a good deal — but it is worth being honest about what it cannot do.
One important caveat on oximeters: they overestimate oxygen levels in people with darker skin, sometimes significantly. A reading that looks acceptable can conceal a genuinely low level. We take that into account, and you should treat how you actually feel as the more reliable signal.
We cannot listen to your chest, and we cannot measure your oxygen ourselves. Where the picture suggests pneumonia, or where you are breathless at rest, that needs in-person assessment — and we will arrange it rather than prescribing blind.
For most chest infections in otherwise healthy people, they are not — and taking them causes side effects, C. difficile risk and resistance without shortening the illness.
Antibiotics are appropriate for: suspected pneumonia, significant underlying lung disease, immunosuppression, frailty, or someone who is clearly deteriorating.
A genuinely useful middle path: a prescription to hold and use only if you are not improving in a few days, or if you get worse. Most people never use it, and it avoids both unnecessary antibiotics and a second appointment.
Where you have asthma or COPD, the infection will make it worse. That may mean stepping up inhalers, a course of steroids, or using a rescue pack — and it is worth reviewing inhaler technique, since poor technique is extremely common and undoes a great deal of treatment.
Flu, pneumococcal and COVID vaccination where eligible. Pneumococcal vaccination in particular is under-taken by people with COPD, diabetes or no spleen, who benefit most.
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The single highest-yield thing available here. Airway lining recovers, infections become less frequent and less severe, and the decline in lung function slows. It is never too late, and support genuinely doubles the odds — see our smoking cessation page. Vaping is less harmful than smoking but is not neutral for the airways.
Three weeks on average, six to eight not unusual. Setting that expectation is the single best defence against unnecessary repeat antibiotics — and against the worry that something is being missed. What matters is the direction: gradually improving is fine, even if slowly. Getting worse is not.
A cough lasting more than three weeks in a smoker, or in anyone over 40, needs a chest X-ray. Not another antibiotic, not a wait-and-see. This is how lung cancer is caught early, and it is the single most important sentence on this page for anyone who smokes.
Most chest infections are viral, settle without antibiotics, and the cough outlasts everything else. A cough after a chest infection commonly lasts three to four weeks, and sometimes longer — that is normal recovery, not treatment failure, and knowing it prevents a great many unnecessary antibiotic courses.
Your NHS GP treats chest infections free, and NHS 111 is the right route out of hours.
Simple measures cost a few pounds and are genuinely what helps: fluids, paracetamol or ibuprofen, honey and lemon — which has better evidence for cough than most cough medicines — and rest.
Where a private consultation is genuinely worth paying for is the assessment of severity, because that is the decision that matters: is this a self-limiting bronchitis or is it pneumonia? The features that distinguish them are breathlessness at rest, a fast breathing rate, confusion, and feeling genuinely unwell rather than simply having a cough.
The honest limitation is that we cannot listen to your chest, which is part of that assessment. A careful history covers much of it, and where the examination decides it we will say so and direct you to be seen.
What needs urgent assessment: breathlessness at rest, chest pain on breathing, coughing blood, confusion or drowsiness, or a fever that is not settling after several days. Anyone who is frail, immunosuppressed, or has COPD warrants a lower threshold.
NICE NG120, Cough (acute): antimicrobial prescribing, is the governing guideline. It recommends no antibiotic or a back-up prescription for most people with acute cough or bronchitis, since it is usually self-limiting, and notes the cough may last three to four weeks.
NG120 recommends considering honey or an over-the-counter cough preparation for symptom relief.
NICE NG138, Pneumonia (community-acquired): antimicrobial prescribing, and CG191 cover the assessment of severity, including use of the CRB-65 score in primary care to guide the decision to treat at home or admit.
NG120 sets out the features prompting immediate antibiotics or referral — systemic illness, suspected pneumonia, and higher-risk groups including those with significant comorbidity or immunosuppression.
NICE NG12 covers persistent cough as a criterion for urgent chest X-ray to exclude lung cancer.
No — and this is one of the most persistent misunderstandings there is. The green colour comes from your own immune cells, not from bacteria. Clear, yellow or green phlegm tells you nothing useful about whether antibiotics will help. What matters is how unwell you feel, whether you are breathless, and whether you are getting better or worse.
Longer than you think. The average cough after a chest infection is around three weeks, and six to eight is not unusual — even after the infection has gone — because the airway lining takes that long to repair. Judge it by direction, not duration: slowly improving is fine; getting worse is not.
Bronchitis is a cough in someone who otherwise feels reasonably alright. Pneumonia makes you feel genuinely ill — high fever with shivering, breathlessness at rest, faster breathing, and sharp chest pain worse on breathing in. In older people, confusion is often the first sign, sometimes with barely any cough at all. That combination needs same-day assessment.
Partly, and we will be honest about the rest. We cannot listen to your chest or measure your oxygen. We can take a detailed history, use your breathing rate and temperature, prescribe where it is clearly appropriate, and arrange a chest X-ray. Where the picture suggests pneumonia or you are breathless at rest, we will arrange for you to be seen rather than prescribe blind.
If you have a lung condition, yes — they are inexpensive and useful. One important caveat: pulse oximeters overestimate oxygen levels in people with darker skin, sometimes enough to mask a genuinely low level. Do not let a reassuring number override how you actually feel or how hard you are working to breathe.
Worth investigating rather than accepting. Common reasons: undiagnosed or poorly controlled asthma or COPD, smoking, poor inhaler technique, reflux, bronchiectasis, or immune problems. Repeated infections in the same part of the lung particularly need a look, as does any cough lasting beyond three weeks in a smoker.
Not really, and we would rather tell you than sell you one. Honey in a warm drink has better trial evidence than most over-the-counter cough preparations — though not for babies under one. Sleeping propped up helps night-time coughing more than any syrup.
August 23, 2026
Ongoing
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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Same day, usually
20 minutes
Yes, with your consent
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£40 for 20 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
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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