Acute Bronchitis: How Long the Cough Lasts, What Helps and When You Need Antibiotics

The cough from a chest infection often lasts much longer than people expect: three weeks is common. Most acute bronchitis is caused by viruses, so antibiotics don’t help. Knowing what’s normal, and what isn’t, saves worry and unnecessary medicines.

Imagine you had a cold two weeks ago. The runny nose has gone, but now you have a deep, rattly cough bringing up yellow phlegm, your chest feels sore, and you’re tired. You’re sure you need antibiotics. The nurse listens to your chest, checks your breathing and temperature, and explains why they won’t help, and what will.

Symptoms of acute bronchitis

• A cough, often bringing up clear, yellow or green mucus
• A sore chest from coughing
• Mild wheeze or breathlessness
• Tiredness, sore throat, blocked nose and aches

Green or yellow phlegm doesn’t automatically mean a bacterial infection. Most symptoms improve within three weeks, although a cough can sometimes linger longer.

What helps

• Rest and plenty of fluids
• Paracetamol or ibuprofen for aches and fever, following the pack
• Honey and lemon in warm water to soothe the throat (not for babies under 1)
• Sleeping propped up on extra pillows
• Not smoking, and avoiding smoky places

Evidence for over-the-counter cough medicines is limited. Ask a pharmacist before using them, and don’t give them to young children.

But when do you need antibiotics or urgent care?

Antibiotics are only needed if a doctor or nurse thinks there’s a bacterial infection such as pneumonia, or you’re at higher risk of complications. Get checked if:

• Your cough lasts more than three weeks or keeps getting worse
• You have a high temperature for more than a few days, or feel very unwell
• You’re older, pregnant, or have a heart, lung, kidney or immune condition
• You’re coughing up blood

Call your emergency number if you’re struggling to breathe, can’t finish sentences, have chest pain, or your lips or skin look blue or grey. A cough lasting more than three weeks can also be a sign of conditions such as tuberculosis or lung cancer, so don’t ignore it.

Sources: NHS (Bronchitis; Chest infection), NICE guideline on cough (acute): antimicrobial prescribing, US Centers for Disease Control and Prevention (Chest cold), World Health Organization (antimicrobial resistance). This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.