Taking Antibiotics For Pneumonia: What You Need To Know

Pneumonia¹ is an infection of the lungs, resulting in inflammation of the lungs’ parenchyma. This is your lungs’ function tissue and includes the alveoli, which provide oxygen to our blood. Subsequent fluid or pus build-up in these alveoli can lead to decreased oxygen uptake and the symptoms of pneumonia, such as a cough, fever, breathlessness, or chills. 

Various things can cause pneumonia, including bacteria, viruses, and fungi. Depending on where you caught pneumonia (hospital-acquired or community-acquired), the incidence of these types of pneumonia differs. In most cases, hospital-acquired pneumonia causes a more severe infection due to patients being already ill and the disease agents having antibiotic resistance. 

Pneumonia can result in a mild sickness that you can overcome in a matter of days to a life-threatening illness requiring urgent hospitalization. 

According to the Centers for Disease Control and Prevention (CDC), 1.5 million² people were diagnosed with pneumonia in emergency rooms in 2018. Almost 45,000 deaths occurred in 2020 in the United States alone. The World Health Organization (WHO) reports that pneumonia causes 14%³ of all deaths in children under five, most in resource-poor countries.

Thankfully, many pneumonia treatments are available. Antibiotics can completely cure the most prevalent type, bacterial pneumonia.

Causes of pneumonia

Bacteria and viruses cause pneumonia; however, fungal pneumonia can also occur when the immune system is weak, such as in people with HIV. This can cause a severe lung infection.

Viral pneumonia is typically a milder disease. Some viruses, such as SARS-CoV-2, put you at risk for secondary bacterial pneumonia.

Bacteria are a leading cause of pneumonia. In some cases, they cause serious infections that can be life-threatening, depending on the bacterial type and strain causing the infection. The symptoms of bacterial pneumonia can develop gradually or rapidly and cause multiple infection areas within the lungs. 

We can classify pneumonia as typical or atypical based on the type of bacteria. The bacterial types that generally cause pneumonia are listed below: 

Typical:

• Streptococcus pneumoniae

• Staphylococcus aureus 

• Escherichia coli

• Moraxella catarrhalis

Atypical:

• Mycoplasma pneumoniae

• Chlamydophila pneumoniae

• Legionella pneumophila

Symptoms of bacterial pneumonia

The symptoms of pneumonia are generally the same whether the cause is viral, bacterial, or fungal. However, symptoms may change depending on the severity of the infection, your age, or your overall health. General symptoms of pneumonia may include 

• A dry or wet/productive cough

• Chest pain

• Fatigue or lethargy

• Fever or chills

• Confusion

• Nausea

• Shortness of breath

For adults over 65, a low body temperature may signify pneumonia and sepsis. Infants or young children may also present with pale skin, crying, restlessness, and loss of appetite.

Using antibiotics for pneumonia

If you’re infected with pneumonia-causing bacteria, the gold-standard treatment is antibiotics. Antibiotic types work in different ways and can inhibit or kill various types of bacteria. Your doctor will choose an antibiotic based on: 

• The type and strain of bacteria causing the infection

• The severity of the infection and its potential for antibiotic resistance

• If you are at a higher risk of having a bad infection

• Allergies to certain types of antibiotics, such as penicillin

The types of antibiotics that your doctor may prescribe you are:

• For adults under 65 who are generally healthy: Amoxicillin along with a macrolide antibiotic or doxycycline. However, some guidelines call for amoxicillin-only therapy.

• For adults over 65 with comorbidities: Augmentin (a mix of amoxicillin and clavulanic acid) and a macrolide antibiotic or doxycycline.

• For adults allergic to penicillins: Antibiotics such as third-generation cephalosporins, a macrolide, or doxycycline. These decrease the risk of an allergic reaction.

• For hospitalized people with pneumonia not caused by MRSA: Antibiotics such as a combination of beta-lactams, macrolides, or respiratory fluoroquinolones.

• For hospitalized people with MRSA or pseudomonas: A combination of antibiotics such as antipseudomonal/anti-pneumococcal beta-lactam, vancomycin, linezolid, or antipseudomonal fluoroquinolones.

Children with bacterial pneumonia can tolerate only a few antibiotics; however, some antibiotics are inappropriate for children due to the potential side effects. These are the types of antibiotics that doctors use for children:

• For most children with suspected bacterial pneumonia: Oral amoxicillin.

• For children with atypical pneumonia: Macrolide antibiotics.

• In children allergic to penicillins: A different type of antibiotic, such as fluoroquinolone antibiotics; however, this also depends on the bacterial type causing pneumonia.

• For children hospitalized with pneumonia: Ampicillin, penicillin G, or cephalosporins (second or third-generation). However, this also depends on your child's vaccination status and the suspected infectious agent.

• For hospitalized children infected with atypical bacterial strains: They may need multiple antibiotics, called combination therapy. This is due to the risk of antibiotic-resistant bacteria. Antibiotics such as macrolides or beta-lactam antibiotics may be used if this is the case.

• For children infected with Methicillin-resistant Staphylococcus aureus (MRSA): A combination of antibiotics, such as clindamycin or vancomycin, with a beta-lactam antibiotic.

Depending on the doctor, hospital, or country, doctors may use different antibiotics for different situations.

Advice when taking antibiotics

For antibiotics to work, you should follow some guidelines. These include:

• Do not share antibiotics with others.

• Do not save antibiotics for a later date.

• Do not take antibiotics prescribed for someone else.

• Take your antibiotics exactly as your doctor prescribes and for the whole course.

Antibiotic side effects

Every medication you take brings a chance of side effects. Side effects of antibiotics may include:

• Vomiting and nausea

• Diarrhea

• Phototoxicity (sensitivity to bright lights)

• Abdominal pain

• Rash

• Headache

• Constipation  

Additionally, people taking antibiotics also have a slight chance that an allergic reaction may occur. Symptoms to watch out for include:

• Skin rash

• Coughing

• Wheezing

• Tightness of the throat

In rare cases, anaphylaxis may occur, which requires urgent medical care. Signs include:

• Feeling lightheaded

• Breathing difficulties

• Rapid heartbeat

• Confusion or anxiety

• Loss of consciousness

• Sweating and clammy skin

The lowdown

Bacterial pneumonia is one of the most common types. The gold-standard treatment for bacterial pneumonia is antibiotics, which can kill or inhibit the bacteria to stop the infection.

Many antibiotics are available, and depending on various factors, your doctor may use different antibiotics to treat the infection.