Types, how long you will take them

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If you have been diagnosed with bacterial pneumonia, you will likely be prescribed antibiotics to treat it. Antibiotics kill bacteria or make them unable to replicate.

Your doctor may prescribe one of several antibiotics for pneumonia. Review what pneumonia is, what treatment for pneumonia may involve, and why your doctor may choose one pneumonia medication over another.

Very good / Michela Buttignol


Pneumonia is an infection of the lower respiratory tract. These are infections of the lungs or lung structures, such as the bronchi. Pneumonia can make it harder to breathe because the air sacs in the lungs that exchange oxygen with carbon dioxide fill with fluid.

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

Viral pneumonia, caused by viruses that also cause colds or flu, usually 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 are spreading.

Recovering from viral pneumonia can take up to three weeks. You can treat fever and pain from pneumonia with over-the-counter medications. Antibiotics won’t help you recover faster if a virus is causing your pneumonia.

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

Pneumococcal vaccination

One of the best ways to prevent bacterial pneumonia is through 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 diseases. Regular use of these vaccines has reduced rates of bacterial pneumonia, even in unvaccinated adults, due to herd immunity.

PCV13 (Prevnar 13) is recommended for:

  • Children under 2 years old
  • Children aged 2 to 18 with certain medical conditions

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

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

PPSV23 (Pneumovax23) is recommended for:

  • Children aged 2 to 18 with certain medical conditions
  • Adults 19 years and older who receive the PCV15 vaccine

Types of antibiotics for pneumonia

There are several types of antibiotics that work in slightly different ways. Some are more commonly used to treat pneumonia than others depending on factors such as:

  • The bacteria responsible for the infection
  • The severity of the infection
  • If you belong to a group of patients most at risk of pneumonia

The types of antibiotics your doctor can usually prescribe for pneumonia are:

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

Antibiotics prescribed for children with pneumonia include the following:

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

How your doctor chooses

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

  • Your age: People 65 and older are at greater risk of serious complications from pneumonia infections.
  • Your health history: A history of smoking, lung disease, or other conditions can influence a person’s ability to fight infections.
  • The exact infection you have: Your doctor can take a sample and test it for bacteria. They can then choose an antibiotic based on your specific infection.
  • Your previous experiences with antibiotics: Be sure to tell your doctor if you are allergic to any medications, if you have had bad reactions to antibiotics in the past, or if you have developed an infection that is resistant to antibacterials.
  • 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 usually choose your antibiotic prescription based on the drugs they think are most effective and cause the fewest side effects.

How long will you take them

A course of antibiotics for the treatment of uncomplicated pneumonia usually lasts five to seven days. One course will usually be enough to cure your pneumonia. In some cases, you may need more antibiotic treatment if your infection does not start to improve or seems unresponsive to medication.

Keep in touch with your doctor to make sure your infection clears up. You’ll probably start to feel better and experience some symptom relief one to three days after you start treatment for pneumonia, but it may take a week or more for your symptoms to completely go away.

Taking your medications as prescribed, especially antibiotics, is extremely important. Even if you feel better, you have to take the whole course.

Do not stop taking antibiotics early, even if your symptoms improve, as the infection will not be completely treated and may become resistant to antibiotics. This will make the treatment more complicated. If you experience side effects, talk to your doctor. Only stop your treatment if your doctor tells you that you can.

Side effects

Antibiotics are serious drugs and can have unpleasant side effects. These may include:

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

Ask your doctor about potential serious side effects to watch out for.

Antibiotics work by killing bacteria, but our bodies are full of bacteria. There are more bacterial cells in our body 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 all the bacteria they can find, even the good ones. This indiscriminate killing leads to some complications, as harmful bacteria can invade parts of our body evacuated by the bacteria that the antibiotic has killed.

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

Summary

Antibiotics are used to treat bacterial pneumonia. The antibiotic prescribed depends on the type of bacteria, your age, your medical history, etc. You will often take the antibiotics for five to seven days. It is important to complete the full course. Side effects may occur, which you should report to your doctor.

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