Acute bronchitis
Also called: chest cold, bronchitis, chest infection (bronchitis), acute cough with bronchitis
Acute bronchitis, often called a chest cold, is swelling of the main airways in the lungs, usually caused by a virus. It causes a cough that can last up to 3 weeks. Most people get better on their own, and antibiotics usually do not help.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
Acute bronchitis is inflammation (swelling and irritation) of the bronchi, the large tubes that carry air into the lungs. It often starts after a cold or flu, when the infection spreads down from the nose and throat into the chest. The main symptom is a cough, which may bring up clear, yellow or green mucus (phlegm). 'Acute' means it comes on suddenly and does not last long. It is different from chronic bronchitis, a long-term cough that is part of chronic obstructive pulmonary disease (COPD).
Viruses cause around 9 in 10 cases in healthy adults. These include the viruses that cause colds, flu, COVID-19 and respiratory syncytial virus (RSV) infection. Bacteria are a less common cause. Smoke, dust and air pollution can also irritate the airways and make bronchitis more likely or worse.
Most people get better without any treatment. Fever and aches usually settle within about a week, but the cough often lasts 2 to 3 weeks, and sometimes longer. Because the cause is nearly always a virus, antibiotics do not help most people. Studies show they shorten the cough by only about half a day on average, while causing side effects such as diarrhoea and nausea. Doctors keep antibiotics for people who are very unwell, those at higher risk of complications, or when another infection such as pneumonia or whooping cough is suspected.
In Pakistan: what studies show
No Pakistan study we found looked at acute bronchitis alone, but studies of coughs, colds and other respiratory infections show antibiotics are given very often. In Hazara, pharmacies sold antibiotics without a prescription in 92.9% of visits for an adult respiratory infection, and in Quetta 69.80% of hospital prescriptions for upper respiratory infections included an antibiotic.
- In a study from late 2020 to early 2021 in all eight districts of Hazara Division, people acting as patients with an adult upper respiratory infection were sold antibiotics without a prescription in 92.9% of pharmacy and medical store visits (respiratory infection data, not bronchitis alone).[1] (cross-sectional, data November 2020 - February 2021)
- Across both scenarios in the same Hazara study (respiratory and urine infections), antibiotics were handed over without a prescription at 90.5% of the pharmacies and medical stores visited.[1] (cross-sectional, data November 2020 - February 2021)
- In Lahore between 2019 and 2020, people asking pharmacies for help with a child's upper respiratory infection were given antibiotics without a prescription in 197 of 387 visits (50.9%) (respiratory infection data in children, not bronchitis alone).[2] (cross-sectional, data 1 Nov 2019 - 31 Jan 2020)
- In the same Lahore pharmacy study, a qualified pharmacist was present in only 21.2% of visits.[2] (cross-sectional, data 1 Nov 2019 - 31 Jan 2020)
- At one military hospital's primary care clinic in Quetta in 2021, 69.80% of 4,126 prescriptions for upper respiratory infections included an antibiotic, which the authors said did not match current guidelines (respiratory infection data, not bronchitis alone).[3] (cross-sectional, data 1 March - 31 May 2021)
- In 32 government primary health care centres across 8 cities of Punjab, 81.5% of prescriptions in 2016 included an antibiotic or other antimicrobial (all illnesses, not only chest infections).[4] (cross-sectional, data 2016 (collected retrospectively January-June 2017))
- In 5 public hospitals in Lahore in 2017, 40.8% of children admitted with respiratory tract infections had an error in how their antibiotic was prescribed (children's respiratory infection data, not adult bronchitis).[5] (cross-sectional, data 1 Jan 2017 - 30 Jun 2017)
- At one hospital laboratory in Islamabad, 39.4% of 591 samples from patients of all ages with suspected flu tested positive for influenza virus in 2016-2019, a reminder that viruses, which antibiotics do not treat, cause many chest infections.[6] (cross-sectional, data April 2016 - March 2019)
What we do not know yet: We found no Pakistan study on acute bronchitis itself and no national figures on how often adults get acute respiratory infections, so all numbers here come from wider respiratory-infection studies in single cities or divisions. Pharmacy studies differ (50.9% in Lahore for a child's infection versus 92.9% in Hazara for an adult's), likely because of different places, years and scenarios; a 2017-2019 national influenza burden study and a national pharmacy sale study could not be opened.
Pakistan studies cited
- Ahmad T, Khan FU, Ali S, et al. Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client's study. PLoS ONE 2022;17(2):e0263756. doi:10.1371/journal.pone.0263756. Open source
- Malik UR, Chang J, Hashmi F, et al. A Simulated Client Exploration of Nonprescription Dispensing of Antibiotics at Drugstores for Pediatric Acute Diarrhea and Upper Respiratory Infection in Lahore, Pakistan. Infection and Drug Resistance 2021;14:1129-1140. doi:10.2147/IDR.S301812. Open source
- Hashmi H, Sasoli NA, Sadiq A, et al. Prescribing Patterns for Upper Respiratory Tract Infections: A Prescription-Review of Primary Care Practice in Quetta, Pakistan and the Implications. Frontiers in Public Health 2021;9:787933. doi:10.3389/fpubh.2021.787933. Open source
- Sarwar MR, Saqib A, Iftikhar S, et al. Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan. BMC Infectious Diseases 2018;18(1). doi:10.1186/s12879-018-3407-z. Open source
- Iftikhar S, Sarwar MR, Saqib A, et al. Antibiotic Prescribing Practices and Errors among Hospitalized Pediatric Patients Suffering from Acute Respiratory Tract Infections: A Multicenter, Cross-Sectional Study in Pakistan. Medicina 2019;55(2):44. doi:10.3390/medicina55020044. PMID 30754696. Open source
- Raza S, Usman M, Ahmad I. Seasonal trends of Influenza in Islamabad, Pakistan. Journal of Islamabad Medical & Dental College 2021;10(1):318-322. Open source
Symptoms
- A cough, which may be dry or bring up clear, yellow or green mucus (phlegm)
- Chest discomfort or pain when coughing
- Feeling tired and run down
- Mild fever (raised temperature) and body aches
- Sore throat, blocked or runny nose, like a cold
- Shortness of breath that gets worse with activity
- Wheezing (a whistling sound when breathing), especially in people with asthma
- A cough that lingers for 1 to 4 weeks after the other symptoms have gone
Causes and risk factors
Causes
- Viruses, which cause most cases: for example flu (influenza), cold viruses (rhinovirus), coronaviruses including COVID-19, adenovirus and respiratory syncytial virus (RSV)
- Bacteria, less often, such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Bordetella pertussis (the cause of whooping cough)
- Irritants in the air, such as cigarette smoke, dust and air pollution
- Infection spreading easily from person to person through coughs and sneezes
What makes it more likely
- Smoking, or breathing in other people's smoke
- Living in an area with polluted air
- Crowded living conditions
- Having asthma or allergies
- Contact with someone who has a cold or flu, especially in winter
- Being older, particularly over 65
Complications
Acute bronchitis is usually mild and clears up on its own. The most important complication is pneumonia (an infection deeper in the lung tissue), which can follow bronchitis and needs medical treatment. Older people, pregnant women, babies born early, and people with heart, lung, kidney or liver disease, diabetes or a weak immune system are more likely to become seriously ill. In some people the cough lasts much longer than expected. People with asthma or COPD may find their condition flares up. Rarely, very forceful coughing can cause air to leak around the lung (pneumothorax). Bronchitis can also come back, in up to one in three people.
When to see a doctor
- Struggling to breathe, or lips or skin turning blue, grey or very pale: this is an emergency, go to the nearest hospital or call an ambulance
- Sudden confusion, or a baby who is floppy or hard to wake: get emergency help straight away
- Coughing up blood or blood-stained mucus
- Shortness of breath, or chest pain when breathing or coughing
- High fever with shaking chills, or a fever that lasts more than 5 days
- A cough that lasts more than 3 weeks, or keeps coming back
- Feeling much worse quickly, or having a long-term heart, lung or kidney condition, diabetes or a weak immune system
Diagnosis
Acute bronchitis is usually diagnosed from your symptoms and a simple check-up. The doctor asks about your cough and other symptoms, listens to your chest with a stethoscope, and checks your temperature, pulse and breathing rate. A pulse oximeter (a small clip on the finger) may be used to measure the oxygen level in your blood. In a healthy adult with normal findings, no further tests are usually needed. Yellow or green mucus on its own does not mean you have a bacterial infection or need antibiotics.
A chest X-ray is done if pneumonia is suspected, for example when there is a high fever, a fast heartbeat or fast breathing, unusual sounds in the chest, or in older people. Tests for flu, COVID-19 or whooping cough may be done when these are suspected. If the cough lasts more than 3 weeks, the doctor will look for other causes, such as asthma, COPD, acid reflux or heart problems.
Treatment
- Most people do not need medicines from a doctor. Rest, drink plenty of fluids and expect the cough to last about 2 to 3 weeks.
- Use paracetamol or ibuprofen (if it is safe for you) to ease fever, aches and chest pain. Your doctor or pharmacist decides the dose.
- Antibiotics are not routinely given, because they do not help most people and can cause side effects such as diarrhoea and nausea.
- If you are at higher risk of complications, the doctor may give an antibiotic straight away or a 'back-up' prescription to use only if you get much worse.
- If you are very unwell, or pneumonia or whooping cough is suspected, the doctor will offer an antibiotic. For adults the usual first choice is doxycycline (not in pregnancy), and for children it is amoxicillin. Your doctor decides the medicine, the dose and how long to take it.
- If you have asthma or COPD, or are wheezing, the doctor may suggest an inhaler that opens the airways.
- If symptoms get worse quickly or have not improved after 3 to 4 weeks, see a doctor again so other causes can be checked.
Medicines in Pakistan
Medicines a doctor may use, by group. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| Painkillers and fever reducers | ease fever, body aches and chest pain from coughing; they do not shorten the illness | Paracetamol (350 brands), Ibuprofen (378 brands) |
| Tetracycline antibiotics | first choice for adults only when an antibiotic is needed (very unwell or at higher risk of complications); not used in pregnancy | Doxycycline (80 brands) |
| Penicillin antibiotics | first choice for children and the preferred option in pregnancy when an antibiotic is needed; an alternative for other adults | Amoxicillin (248 brands) |
| Macrolide antibiotics | alternative when an antibiotic is needed and the first choice is unsuitable, for example in penicillin allergy | Clarithromycin (489 brands), Erythromycin (11 brands) |
| Short-acting bronchodilator inhalers | only for people with wheezing, asthma or COPD; not helpful for a cough without these | Salbutamol (42 brands) |
Also used (not yet in our price list): guaifenesin (an expectorant that may loosen mucus; limited evidence, age 12 and over), dextromethorphan (a cough suppressant; limited evidence, age 12 and over), pelargonium (a cough remedy; limited evidence, age 12 and over)
Self-care and prevention
Self-care
- Rest, and stay at home if you have a fever or feel too unwell for your usual activities.
- Drink plenty of fluids, such as water and warm drinks.
- A spoon of honey or honey in a warm drink may soothe the throat and cough. Never give honey to a baby under 1 year old.
- Breathe in steam from a hot shower or a bowl of hot water, or use a clean humidifier, to moisten the air.
- Do not smoke, and keep away from other people's smoke.
- Do not give over-the-counter cough and cold medicines to children aged 6 or under, and do not give aspirin to anyone under 18.
- Cough medicines containing codeine, antihistamines or decongestants are not recommended for this cough.
Prevention
- Wash your hands often with soap and water, and teach children to do the same.
- Cover your mouth and nose when you cough or sneeze, and throw used tissues in the bin.
- Do not smoke, and avoid second-hand smoke and polluted air where you can.
- Keep up to date with vaccines, such as the yearly flu vaccine and pneumonia vaccine if your doctor recommends them.
- Clean surfaces that are touched often, and let fresh air into the home.
Common questions
Do I need antibiotics for bronchitis?
Usually not. Most acute bronchitis is caused by viruses, and antibiotics do not work against viruses. In studies, antibiotics shortened the cough by only about half a day and caused side effects such as diarrhoea and nausea. A doctor may give one if you are very unwell, at higher risk of complications, or if pneumonia or whooping cough is suspected.
How long does acute bronchitis last?
Fever and aches usually go within about a week. The cough often lasts 2 to 3 weeks and can sometimes go on for up to 4 weeks. See a doctor if it lasts longer than 3 weeks or keeps getting worse.
Does yellow or green phlegm mean I need antibiotics?
No. Yellow or green mucus is common in viral bronchitis and does not on its own show a bacterial infection. Doctors decide on antibiotics based on how unwell you are, your other health conditions and signs of pneumonia, not the colour of the mucus.
Is acute bronchitis contagious?
The viruses that cause it spread easily through coughs and sneezes. Cover your coughs, wash your hands often and stay at home while you have a fever to help protect others.
What is the difference between bronchitis and pneumonia?
Bronchitis affects the airways, while pneumonia is an infection in the lung tissue itself. Pneumonia is more likely to cause high fever, chills, worsening breathlessness and feeling very unwell. A doctor may need to examine you and sometimes arrange a chest X-ray to tell them apart.
Sources
- NICE. Cough (acute): antimicrobial prescribing (NICE guideline NG120) (2019).
- CDC. Chest Cold (Acute Bronchitis) Basics | Acute Bronchitis | CDC (2025).
- American Family Physician (AAFP). Acute Bronchitis: Rapid Evidence Review (2025).
- NHS. Bronchitis - NHS (2026).
- MedlinePlus. Acute bronchitis: MedlinePlus Medical Encyclopedia (2026).
- StatPearls (NCBI Bookshelf). Acute Bronchitis - StatPearls (2024).
- Frontiers in Public Health (PMC). Prescribing Patterns for Upper Respiratory Tract Infections: A Prescription-Review of Primary Care Practice in Quetta, Pakistan and the Implications (2021).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.
Related conditions
Common coldInfluenza (flu)PneumoniaAsthmaChronic obstructive pulmonary disease (COPD)