Patient information · Urgent care
Chest infection
how long the cough should last, and when to worry
Most chest infections are viral bronchitis: an irritating cough after a cold, sometimes with phlegm, that clears by itself. The cough routinely lasts three weeks, which is far longer than most people expect. Pneumonia is a different illness, and the difference is in how unwell you feel rather than how much you are coughing.
Call 999 or go to an emergency department if you
- are struggling to breathe at rest, or cannot complete a sentence
- have blue or grey lips or fingertips
- have chest pain that is severe, or worse on breathing in and accompanied by breathlessness
- are coughing up blood
- become confused, drowsy, or difficult to rouse
- have cold, clammy or mottled skin, a very fast heartbeat, or have not passed urine all day
These can indicate pneumonia or sepsis. Older people and those with heart or lung disease can be seriously unwell with fewer obvious signs — confusion alone may be the first sign. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
How long a cough lasts
Green or yellow phlegm is not a sign that antibiotics are needed. The colour comes from the body's own immune cells and appears in viral infections just as readily as bacterial ones.
Why antibiotics are often not prescribed
Acute bronchitis is usually viral. Trials consistently show antibiotics shorten the illness by around half a day at most, while causing diarrhoea, thrush and rashes, and driving antibiotic resistance. Not prescribing is an active clinical decision based on how you are, not an absence of one.
Antibiotics are appropriate when there are signs of pneumonia, when you are significantly unwell, or when you are in a higher-risk group. Sometimes a delayed prescription is the sensible middle path — you hold it and only start if things have not improved in a few days or if you worsen.
Looking after yourself
Helps
- Rest, and plenty of fluids to keep phlegm loose
- Paracetamol or ibuprofen for fever and aching
- Honey and lemon in warm water — as effective as most cough medicines (never honey under one year old)
- Propping yourself up at night with extra pillows
- Stopping smoking, which is the single biggest thing you can do for the cough
Not worth it
- Over-the-counter cough medicines — the evidence for them is very weak
- Cough suppressants in children under six
- Antibiotics left over from a previous illness
- Pushing on at work with a fever
If you are at higher risk
Contact us earlier rather than later if you have COPD, asthma, bronchiectasis, heart disease, diabetes, a weakened immune system, are pregnant, or are over 65. What is a nuisance for a healthy adult can be a serious illness in these groups, and the threshold for examining you and considering a chest X-ray is lower.
If you have a rescue pack of antibiotics and steroids for COPD, use it according to your agreed plan and let us know that you have.
Come back to us if
- you are getting worse rather than better after three days
- your fever persists beyond a few days, or returns after settling
- the cough is still there after three weeks
- you become breathless doing things that were easy before
- you cough up blood at any point, or have unexplained weight loss or night sweats
Reducing your chances next winter
The flu vaccine, COVID vaccine and pneumococcal vaccine all reduce the risk of serious chest infection. They are worth having if you are over 65, pregnant, or have a long-term heart, lung, liver, kidney or immune condition, or diabetes. Ask us which you are eligible for — we can give them here.
Book an appointment if you need your chest examined and oxygen levels checked, a chest X-ray, a sputum sample, or a sick note. We can assess you seven days a week and arrange X-ray quickly through our CQC-registered imaging partners.
Chest examined, X-ray arranged quickly
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.