The Chest Clinic
Respiratory tract infections
What are respiratory infections?
These infections affect the nose, throat, airways or lungs. Colds and flu affect the upper airways; bronchitis and pneumonia involve the lower respiratory tract. Many are caused by viruses, although bacterial infection can occur.
Symptoms and recovery
Cough, a sore throat, a runny or blocked nose, fever and tiredness are common. Most uncomplicated infections improve with time. An acute cough can last three to four weeks, even after other symptoms settle. Worsening symptoms need reassessment rather than assuming the infection is simply taking longer.
How are they assessed?
Your clinician considers how unwell you feel, your breathing, symptoms and underlying health. Examination may include temperature, breathing rate and oxygen levels. Chest imaging or other tests are selected when pneumonia, complications or another diagnosis is suspected; they are not needed for every cold or cough. Repeated infections or persistent symptoms may warrant further investigation.
Treatment
Rest, fluids and suitable pain or fever relief can help. Ask a pharmacist if you are unsure which medicines are suitable for you. Antibiotics do not treat viruses and are not routinely needed for uncomplicated acute bronchitis. They may be appropriate when you are very unwell, have suspected bacterial pneumonia or are at higher risk of complications. Follow the prescribed course and any advice about a back-up prescription.
Steroids and inhalers are not routine treatment for an acute infective cough unless another condition, such as asthma, makes them appropriate. If you have an existing lung condition, follow your individual action plan and seek advice when symptoms change.
When to seek help
Seek prompt GP or NHS 111 advice for worsening breathlessness, coughing up blood, significant deterioration or a cough that is not improving. Call 999 for severe breathing difficulty, blue or grey lips, collapse or sudden confusion. People with weakened immunity or significant heart or lung disease may need earlier review.
Reducing future infections
Wash your hands, cover coughs and follow current advice about staying home when unwell. Discuss recommended vaccinations and stopping smoking with your healthcare team.
Sources and further information
NHS: respiratory tract infections
NICE NG237: assessment of respiratory infection
General information for adults; treatment depends on your assessment.