The Only Times Your Doctor Should Prescribe Antibiotics for Pneumonia (2022)

If you’ve been diagnosed with bacterial pneumonia, you’ll likely be prescribed antibiotics to treat it. Antibiotics kill bacteria or render them unable to replicate.

Your doctor may prescribe one of many antibiotics for pneumonia. Review what pneumonia is, what treatment for pneumonia may entail, and why your doctor may pick one pneumonia medication over the other.

The Only Times Your Doctor Should Prescribe Antibiotics for Pneumonia (1)

Pneumonia is a lower respiratory infection. These are infections of the lungs or lung structures, like the bronchi. Pneumonia may make it harder to breathe because the air sacs in the lungs that exchange oxygen with carbon dioxide fill up with fluid.

Viruses or bacteria can cause different types of pneumonia. Less commonly, a fungus can be the culprit.

Viral pneumonia, caused by the viruses that also cause the common cold or flu, typically goes away on its own with enough time and rest. This type of pneumonia tends to be more seasonal in the fall and winter when cold and flu viruses spread.

Recovering from viral pneumonia could take up to three weeks. You can treat pneumonia's fever and pains with over-the-counter medicines. Antibiotics won't help you get better quicker if a virus causes your pneumonia.

Bacterial pneumonia is more common and needs to be treated with antibiotics to resolve fully, which may take a month or more. Bacterial pneumonia may be caused by the same pathogen that caused the original illness. Or it can be a secondary bacterial infection after a viral illness.

Pneumococcal Vaccination

One of the best ways to prevent bacterial pneumonia is vaccination. There are currently four vaccines available in the United States (PCV13, PCV15, PCV20, and PPSV23) that help protect against a number of bacteria that cause pneumonia and other pneumococcal disease. Regular use of these vaccines has lowered bacterial pneumonia rates, even in nonvaccinated adults, due to herd immunity.

PCV13 (Prevnar 13) is recommended for:

  • Children younger than 2 years old
  • Children ages 2 to 18 years with certain medical conditions

PCV15 (Vaxneuvance) or PCV20 (Prevnar 20) is recommended for:

  • Adults 65 years or older
  • Adults ages 19 to 64 years with certain risk factors or medical conditions

PPSV23 (Pneumovax23) is recommended for:

(Video) Pneumonia - causes, symptoms, diagnosis, treatment, pathology

  • Children ages 2 to 18 years with certain medical conditions
  • Adults 19 years and older who get the PCV15 vaccine or who previously got PCV13

Types of Antibiotics for Pneumonia

There are multiple types of antibiotics that work in slightly different ways. Some are more commonly used to treat pneumonia than others based on things like:

  • The bacteria causing infection
  • The severity of the infection
  • If you’re in a patient group at greatest risk from pneumonia

The types of antibiotics that your doctor might typically prescribe for pneumonia include the following:

  • Healthy adults under 65 years with pneumonia are typically treated with a combination of amoxicillin plus a macrolide like Zithromax (azithromycin) or sometimes a tetracycline like Vibramycin (doxycycline).
  • Adults with other illnesses or who are smokers will usually be prescribed Augmentin (amoxicillin/clavulanic acid), a combination drug that contains both amoxicillin and another antibiotic, the beta-lactam clavulanic acid. Augmentin may be supplemented in these patients with either a macrolide or tetracycline. These other conditions make it difficult for the body to fight off infections and include chronic heart, lung, liver, or kidney diseases, like chronic obstructive pulmonary disease (COPD), diabetes, alcohol use disorder, cancer, and patients without a spleen.
  • Adults who can't take penicillin may be prescribed cephalosporin like Rocephin (ceftriaxone) plus either a macrolide ordoxycycline.
  • Adults who can't take Augmentin because of the beta-lactam will likely be prescribed an inhaled fluoroquinolone like Levaquin (levofloxacin).
  • Hospitalized adults who are not likely to have methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas are treated with either combination therapy of a beta-lactam plus macrolide or with a fluoroquinolone.
  • Hospitalized adults with Pseudomonas will be treated with a combination of an antipseudomonal beta-lactam plus an antipseudomonal fluoroquinolone.
  • Hospitalized adults with MRSA will also be prescribed an anti-MRSA drug like Vancocin (vancomycin)or Zyvox (linezolid).

Antibiotics prescribed for children with pneumonia include the following:

  • Infants, preschoolers, and school-aged children with suspected bacterial pneumonia may be treated with amoxicillin.
  • Children with suspected atypical pneumonia can be treated with macrolides.
  • Children allergic to penicillin will be treated with other antibiotics as needed for the specific pathogen.
  • Hospitalized, immunized children can be treated with ampicillin or penicillin G.
  • Hospitalized children and infants who are not fully vaccinated may be treated with a cephalosporin.
  • Hospitalized children with suspected M. pneumoniaeorC. pneumoniae infection may be treated with combination therapy of a macrolide (such as azithromycin or clarithromycin) and a beta-lactam antibiotic (such as ampicillin or amoxicillin).
  • Hospitalized children with suspected S. aureus infections might be treated with a combination of Vancocin or clindamycin and a beta-lactam.

Easing Symptoms

In addition to antibiotics, lifestyle interventions and over-the-counter treatments can also help ease symptoms. These may include getting rest, drinking fluids, and taking fever reducers.

How Your Doctor Chooses

Your doctor will select the right antibiotic for you based on multiple factors, including:

  • Your age: People 65 and older have a greater risk of serious complications from pneumonia infections.
  • Your health history: A history of smoking, lung diseases, or other conditions may influence a person's ability to fight off infections.
  • The exact infection you have: Your doctor may take a sample and test it for bacteria. They can then pick an antibiotic based on your specific infection.
  • Your previous experiences with antibiotics: Make sure to tell your doctor if you are allergic to any medications, had bad reactions to antibiotics in the past, or have developed an antibacterial-resistant infection.
  • The antibiotic sensitivity of the bacteria: The lab will test the bacteria causing your pneumonia to determine which antibiotics it is sensitive or resistant to.

Doctors typically choose your antibiotics prescription based on what medicines they think will be most effective and cause the fewest side effects.

How Long You’ll Take Them

A course of antibiotics for uncomplicated pneumonia treatment is usually for five to seven days. One course will usually be enough to cure your pneumonia. In some cases, you may need more than one course of antibiotics if your infection doesn’t start improving or it seems like it’s not responding to the medications.

Stay in touch with your doctor to ensure your infection is clearing up. You’ll likely start to feel better and have some symptom relief one to three days after you start your pneumonia treatment, but it may take a week or more for your symptoms to go away completely.

Taking your medication as prescribed, especially for antibiotics, is incredibly important. Even if you’re feeling better, you need to take the entire course.

Do not stop taking antibiotics early, even if your symptoms improve, as the infection would not be fully treated and could become antibiotic-resistant. This will make treatment more complicated. If you’re experiencing side effects, talk to your doctor. Only stop your medication if your doctor tells you it’s OK to do so.

Side Effects

Antibiotics are serious drugs and can have some uncomfortable side effects. These can include:

(Video) Pneumonia Explained! Symptoms, Diagnosis, Labs, Treatment

  • Gastrointestinal discomfort: Nausea, vomiting, diarrhea, upset stomach, loss of appetite, clay-colored stools, and stomach pain
  • Skin issues: Hives, yeast infections (including oral thrush), allergic reactions (skin rash), angioedema (skin swelling), and sensitivity to sunlight

Ask your doctor about any potential severe adverse reactions to watch out for.

Antibiotics work by killing bacteria, but our bodies are full of bacteria. There are more bacterial cells in our bodies than human cells. The vast majority of these bacteria, called our microbiome, are good for us; they help us digest food and support the immune system.

But antibiotics act indiscriminately, killing any bacteria they can find, even good ones. This indiscriminate killing causes some complications, as harmful bacteria may take over parts of our bodies vacated by the bacteria the antibiotic killed.

Some research suggests that taking a probiotic or eating probiotic foods while you’re taking antibiotics can help avoid some of the immediate and long-term effects of antibiotics on your microbiome.

Common and Serious Antibiotic Side Effects in Children

Summary

Antibiotics are used to treat bacterial pneumonia. Which antibiotic is prescribed is based on the type of bacteria, your age, health history, and more. You will often take the antibiotics for five to seven days. Completing the full course is important. Side effects may occur, which you should report to your doctor.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Dandachi D, Rodriguez-Barradas MC. Viral pneumonia: etiologies and treatment. J Invest Med. 2018;66:957-965. doi:10.1136/jim-2018-000712

  2. MedlinePlus. Viral pneumonia.

  3. MedlinePlus. Pneumonia.

  4. Jain S, Self WH, Wunderink RG, et al. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373(5):415-427. doi:10.1056/NEJMoa1500245

  5. Centers for Disease Control. Pneumococcal conjugate vaccine information statement.

  6. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581ST

  7. Ramirez JA. Overview of community-acquired pneumonia in adults. UpToDate.

  8. Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.Clin Infect Dis. 2011;53(7):e25-e76. doi:10.1093/cid/cir531

  9. MedlinePlus. Antibiotics.

(Video) Pneumonia | Causes, Signs And Symptoms, Prevention & Treatment Of Pneumonia

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By Jennifer Welsh
Jennifer Welsh is a Connecticut-based science writer and editor with over ten years of experience under her belt.She’s previously worked and written for WIRED Science, The Scientist, Discover Magazine, LiveScience, and Business Insider.

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FAQs

Do doctors always prescribe antibiotics for pneumonia? ›

If you've been diagnosed with bacterial pneumonia, you'll likely be prescribed antibiotics to treat it. Antibiotics kill bacteria or render them unable to replicate. Your doctor may prescribe one of many antibiotics for pneumonia.

How often do you take antibiotics for pneumonia? ›

More severe pneumonia

You'll usually be given 2 different kinds of antibiotics at the same time, usually for 5 to 7 days but possibly up to 10 days. But you won't necessarily have to stay in hospital that long.

What happens if you don't take antibiotics for pneumonia? ›

If your pneumonia isn't treated, the pleura can get swollen, creating a sharp pain when you breathe in. If you don't treat the swelling, the area between the pleura may fill with fluid, which is called a pleural effusion. If the fluid gets infected, it leads to a problem called empyema.

What do doctors usually prescribed for pneumonia? ›

Pneumonia medications

Commonly prescribed antibiotics include Cipro, Levaquin, and Oracea. Some side effects associated with antibiotics include diarrhea, nerve damage, and allergic reaction. Doctors will sometimes recommend cough suppressants and fever reducers to help treat pneumonia symptoms.

Why do doctors avoid prescribing antibiotics? ›

The consequences are serious: overuse of antibiotics is fueling the rise of drug-resistant superbugs, and patients can suffer significant side effects from drugs they don't really need.

Why do doctors prescribe unnecessary antibiotics? ›

So why is there so much inappropriate prescribing of these lifesaving drugs? Many factors drive this unnecessary use, including: Patient satisfaction and pressure. Patients or their families may expect to get a prescription at an office visit, whether or not an antibiotic is necessary.

What is the best antibiotic to treat pneumonia? ›

In otherwise uncomplicated pneumonia, azithromycin is the initial drug of choice, as it covers most of the potential etiologic agents, including Mycoplasma species.

Can pneumonia resolve itself? ›

Mild pneumonia may be healed by the body's defense system. Mild pneumonia may be healed by the body's defense system. However severe cases of pneumonia require medical attention especially viral pneumonia. Pneumonia may be usually treated at home by drinking sufficient fluids and having sufficient rest.

How long does it take to recover from pneumonia with antibiotics? ›

It may take time to recover from pneumonia. Some people feel better and are able to return to their normal routines in 1 to 2 weeks. For others, it can take a month or longer.

What is oxygen levels with pneumonia? ›

The present study suggests that in acutely infected nursing home patients, a decrease in oxygen saturation of >3% from baseline, as well as a single oxygen saturation of <94, should suggest pneumonia. A decrease from baseline of <4% or a single oxygen saturation of 94 or higher suggests that pneumonia is unlikely.

Will Zpack clear up pneumonia? ›

The antibiotic that's sold as Zithromax, Zmax or sometimes referred to as a "Z-Pack" is prescribed to treat bacterial infections such as bronchitis, pneumonia, or ear infections.

What walking pneumonia feels like? ›

Walking pneumonia can still make you miserable, with cough, fever, chest pain, mild chills, headache, etc. It feels more akin to a bad cold, and despite what the term "walking" implies, taking care of yourself is the best path to recovery.

Can pneumonia clear up on its own? ›

Mild cases of pneumonia can go away on their own if you manage your symptoms and get adequate rest. Home treatment for pneumonia includes getting plenty of rest, drinking adequate fluids, steamy baths or showers, fever reducers, and avoiding smoking. In severe cases of pneumonia, hospitalization may be needed.

What is the most common treatment for pneumonia? ›

Mild pneumonia can usually be treated at home with rest, antibiotics (if it's likely be caused by a bacterial infection) and by drinking plenty of fluids. More severe cases may need hospital treatment.

What is the first line treatment for pneumonia? ›

Pneumonia should be treated with antibiotics. The antibiotic of choice for first line treatment is amoxicillin dispersible tablets. Most cases of pneumonia require oral antibiotics, which are often prescribed at a health centre.

How do u test for pneumonia? ›

A chest X-ray looks for inflammation in your lungs. A chest X-ray is often used to diagnose pneumonia. Blood tests, such as a complete blood count (CBC) see whether your immune system is fighting an infection. Pulse oximetry measures how much oxygen is in your blood.

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