What causes a chest cold?

An infection in the lining of the tubes (the “bronchi”) that carry air into your lungs. When these tubes get infected, they swell, and mucus (thick fluid often called “phlegm” or “sputum”) forms. The infection is almost always caused by a virus, and antibiotics do not help clear the infection more quickly.

I have a bad cough. Should I be worried?

No. A cough actually helps to defend your lungs by making sure that any phlegm (or sputum) is coughed up rather than settling in your lower lungs where it can cause a more serious infection. Your cough will probably be the last symptom of your chest cold to get better, and may take up to 2-3 weeks, even if you take medication.

What is the best treatment?

The best treatment is to relieve your symptoms while your body fights off the infection:

• Drink lots of fluids, like fruit juices and tea-this can help thin out your phlegm, making it easier to cough.

• Increase the moisture in the air you breathe. The best way to do this is with a vaporizer (cold mist).

• Take acetaminophen (e.g., Tylenol®) if you have fever, aches, or pains.

• Suck a sweet or lozenge-you may find it soothing.

• Avoid breathing irritating substances. If you smoke, stop. Smoking damages the linings in your breathing tubes and makes it easier for viruses to cause infection. Smoking also slows down the healing, so it takes longer for you to get well.

When do antibiotics help?

For patients who are otherwise healthy, we know that

• Antibiotics don’t help chest colds and coughs get better more quickly.

• Antibiotics can create bothersome side effects such as thrush, rashes, nausea, vomiting, and diarrhea.

• It isn’t sensible to take antibiotics when you don’t need them. Overusing antibiotics produces germs that are resistant to treatment, meaning that the medicine may not work when it’s really needed.

There may be some situations when antibiotics may help, but there is no sign of any illness that needs antibiotics now. Although it is unusual, some people are killed by ill effects of antibiotics. Unless you have a lot to gain, you probably don’t want to take even a small chance of a serious reaction or side effect caused by an antibiotic.

Is there anything else I should watch for?

Be sure to call your doctor if:

• you have trouble breathing even when you aren’t coughing

• your cough gets worse or is still present after 2-3 weeks, even when you follow instructions

• you have a high fever (more than 38°C)

• you cough up blood

• you have any other new or worrying symptoms

Adapted from: I’ve Got a Troublesome Cough: Will An Antibiotic Make Me Feel Better?

Macfarlane J,et al. BMJ 2002;324:91-4.; “Acute Bronchitis”, American Academy of Family Physicians 2001 (www.familydoctor.org) © The Foundation for Medical Practice Education, www.fmpe.org