What are the Best Antibiotics for Pneumonia?

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
December 9, 2021

When a person contracts pneumonia, the air sacs in one or both lungs, called alveoli, fill with pus or fluid.

This fluid can make it difficult to breathe. While pneumonia can be mild, it can also cause severe illness, especially in young children, older adults, and those with other medical problems.

In 2019, more than 40,000 Americans died of pneumonia.

Pneumonia happnes when a virus or bacteria that’s living in your body—in your nose, sinuses, or mouth, for example—spreads into your lungs.

You may also directly breathe the virus or bacteria into your lungs, triggering pneumonia. 

Pneumonia is typically caused by viruses or bacteria.

Antibiotics won’t help with viral pneumonia.

Bacterial pneumonia is more common, and usually more severe, and can sometimes occur secondary to a viral infection.

If your doctor suspects that you have bacterial pneumonia, they will treat you with antibiotics.

In this article, I’ll explain how pneumonia is diagnosed, and when and how it’s treated with antibiotics.

I’ll also talk about when pneumonia requires hospitalization.

I’ll also tell you when you should talk to your doctor to see if a persistent cough, shortness of breath, or other upper respiratory symptoms could be pneumonia.

Need antibiotics?

Our physicians can prescribe antibiotics for various conditions, but only if necessary. Chat with a provider to see which treatment option is best for you.

Get Started

Types of Antibiotics for Pneumonia

Pneumonia is a respiratory infection that affects the lower part of the respiratory system, primarily the lungs or the bronchi.

The bronchi are the air passages that connect the lungs to the windpipe.

Because pneumonia causes the air sacs in your lungs fill with pus and fluid, pneumonia can make it harder to take in oxygen and expel carbon dioxide.

Pneumonia is typically caused by a virus or bacterial infection.

Sometimes fungal infections can lead to pneumonia, but that is rarer, and typically occurs in people with weak immune systems due to other diseases.  

Viral pneumonia will often resolve on its own, though it still frequently requires medical care for supportive treatment.

Sometimes pneumonia occurs during or after another viral illness, like the flu or a cold.

If your pneumonia is caused by a virus, antibiotics won’t help unless there is also a secondary bacterial infection. 

If you have bacterial pneumonia, you will need antibiotics to prevent complications and to help your body clear the infection.

Even with antibiotics, it can still take 4-6 weeks to recover from bacterial pneumonia.

Most bacterial pneumonia that is community-acquired (meaning you do not get it while you are in the hospital) comes from the bacteria Streptococcus pneumoniae.

There are several different  antibiotics are effective at treating this bacterial infection.

Azithromycin

Azithromycin is a first-line treatment for healthy adults under age 65 with bacterial pneumonia.

It is often paired with another antibiotic like doxycycline or amoxicillin.

Azithromycin is currently being studied for its effectiveness in treating secondary bacterial pneumonia that is sometimes associated with COVID-19.

Patients who are allergic to penicillin or amoxicillin may be given a cephalosporin antibiotic along with azithromycin or doxycycline.

Clarithromycin

Clarithromycin is another macrolide antibiotic that is commonly used for pneumonia.

It is often used with other antibiotics, particularly in older adults or in those with compromised immune systems.

Tetracycline

Tetracycline is in the same class of antibiotics as doxycycline and minocycline.

It is used to treat pneumonia, STIs, UTIs, and other bacterial infections.

Other antibiotics

Research is ongoing to identify the most effective ways to treat bacterial pneumonia.

Recarbrio is a newer combination antibiotic that pairs imipenem-cilastatin with relebactam.

It is used for treating hospital-acquired pneumonia, secondary pneumonia infections, and ventilator-associated pneumonia.

Lefamulin is another recent antibiotic that is FDA-approved for treating community-acquired pneumonia. 

Your doctor will choose the right antibiotic combination for you based on your age, the severity of illness, your other medical problems,, and medication allergies.

Children with pneumonia are commonly treated with amoxicillin, ampicillin, cephalosporin, and other macrolide-class antibiotics.

For infections caused by Mycoplasma pneumoniae, otherwise referred to as walking pneumonia, penicillin-derived antibiotics are ineffective.

That’s because penicillin-derived antibiotics attack the cell wall of bacteria, and mycoplasma bacteria don’t have cell walls, so they are ineffective.

Instead, macrolides and tetracyclines are most often used to treat this common and milder form of pneumonia.

Walking pneumonia such as that caused by mycoplasma commonly follows a viral infection, like a cold, and may happen more frequently in children and young adults.

Diagnosis for Pneumonia

If you get a cold or the flu and you don’t seem to be improving within 7-10 days, especially if you feel difficulty breathing, a persistent cough or fever, talk to your doctor.

They will evaluate your symptoms, perform an exam, and may have a chest X-ray done to confirm that you have pneumonia.

Symptoms

Pneumonia does not always produce the same symptoms.

Symptoms can range in severity, and children may  have different symptoms than adults.

Newborns, older adults, and people with weakened immune systems may have milder symptoms, but this does not mean that they are less ill.

Common pneumonia symptoms include:

It is possible to have pneumonia without fever or the other common symptoms listed above, so if you feel sick and have an upper respiratory infection that’s not getting any better, see your doctor. 

Chest X-ray

The primary way to confirm the diagnosis of pneumonia is with a chest X-ray, which will show a consolidation of fluid in your lungs.

Other tests, including labs and sputum cultures, may be used to differentiate between viral or bacterial pneumonia, and to determine the severity of the infection.

Treatment for Pneumonia

Treatment for pneumonia depends on the symptoms, severity of illness, and other co-existing health factors.

If you aren prescribed antibiotics for pneumonia, they will likely be prescribed for 5-10 days, depending on which antibiotic is used and the severity of your infection. 

It is always important to complete the entire course of antibiotics and to take them as prescribed, even if you start to feel better quickly.

If you have concerns about the length of your prescription, speak to your doctor.

Hospitalization

Each year, 1.5 million people visit emergency departments because of pneumonia.

Patients may be hospitalized for pneumonia if they are at risk for complications, or if they are having trouble breathing.

Even if they seem to be breathing easily, patients may also require admission to the hospital if their oxygen saturation levels are too low.

The average hospital stay for pneumonia is 3-5 days.

You may be sent home from the hospital before you are feeling completely better.

Sometimes breathing treatments or oxygen are required for at-home care following hospitalization.

Lifestyle and home remedies

If you have bacterial pneumonia, you must be treated with an antibiotic.

Certain lifestyle  changes and home remedies may be helpful to alleviate symptoms or speed up your recovery.

Here are some things to try:

  • Gargle salt water or drink warm tea to help soothe a sore throat
  • Drink a cup of caffeinated coffee, which might ease feelings of breathlessness
  • Over-the-counter pain relievers, like acetaminophen or ibuprofen, can help ease fever, discomfort, and aches
  • Drink plenty of fluids – it’s very important to stay well hydrated to help your body fight off the infection.
Need antibiotics?

Our physicians can prescribe antibiotics for various conditions, but only if necessary. Chat with a provider to see which treatment option is best for you.

Get Started

When to See a Doctor

If you have been sick with what seems like a cold or the flu without improvement for 5-7 days, check in with your doctor.

This could be a sign that you have pneumonia or have developed a secondary infection.

Call your doctor sooner if you have a high fever, have trouble breathing, or otherwise feel like you are getting worse.

If you have a compromised immune system, are over age 65, or have other medical problems, call your doctor sooner.

Children who have symptoms of pneumonia should be seen by their pediatrician right away, since they may not display common signs of pneumonia, even if they are very ill.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

What kind of antibiotic is good for pneumonia?
Several types of antibiotics are used for bacterial pneumonia. The type that is most effective depends on the patient’s age, health, drug allergies, and the cause of the illness. Walking pneumonia, or atypical pneumonia, does not respond to penicillin. It may be effective for bacterial community-acquired pneumonia. Your doctor will prescribe an antibiotic that takes into account all of your health needs.
What is the first-line treatment for pneumonia?
The first-line treatment for pneumonia in adults is macrolide antibiotics, like azithromycin or erythromycin. In children, the first-line treatment for bacterial pneumonia is typically amoxicillin.
What is the best antibiotic to treat COVID pneumonia?
Pneumonia caused by COVID-19 is viral, but secondary bacterial infections may occur, requiring antibiotic treatment. Doxycycline has been used for COVID-19 patients since it also has an anti-inflammatory effect and can concentrate in lung tissue. Azithromycin is also being tested for effectiveness in COVID-19 patients.
What is the most common treatment for pneumonia?
The most common treatment for bacterial pneumonia is macrolide antibiotics. If pneumonia is caused by a virus, antibiotics won’t work, but antiviral drugs or NSAID pain relievers may be used.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.

K Health logo (used on certain page templates)