The Best Antibiotics for Pneumonia

Antibiotics for pneumonia include Zithromax (azithromycin), clarithromycin, and Erythrocin (erythromycin). Azithromycin is often the first-line treatment since it is effective against many different microbes that can cause pneumonia.

Antibiotics treat pneumonia caused by bacteria and some types caused by fungi. They don’t treat viral pneumonia. The antibiotic your healthcare provider prescribes will depend on factors such as the type of pneumonia you have, your age, and your medical history.

Adults with Pneumonia

Antibiotics can treat bacterial pneumonia. They work by killing bacteria or rendering them unable to replicate. Antibiotics won’t help you get better quicker if your pneumonia is caused by a virus.

Some of the most common antibiotics used to treat adults with pneumonia include:

• Amoxil (amoxicillin): The first-line treatment for nonhospitalized people with mild to moderate pneumonia.
• Amoxicillin-clavulanate: Prescribed to people who have other health conditions, smoke, or have used antibiotics in the last 3 months.
• Augmentin (amoxicillin/clavulanic acid): A combination drug containing amoxicillin, beta-lactam clavulanic acid, and a macrolide. May be prescribed to people who smoke or those who have other illnesses.
• Augmentin plus Vibramycin (doxycycline): May be prescribed to people who smoke or those who have other illnesses.
• Azactam or Cayston (aztreonam): Prescribed to adults who can’t take penicillin.
• Cephalosporins (such as ceftriaxone): Third, fourth, or fifth-generation cephalosporins may be prescribed to adults who can’t take penicillin.
• Cleocin (clindamycin): May be used to treat aspiration pneumonia.
• Fluoroquinolones (levofloxacin, gemifloxacin): Prescribed to adults who can’t take Augmentin.
• Non-beta-lactam antibiotics (clindamycin, vancomycin): Prescribed to adults who can’t take penicillin.
• Nuzyra (omadacycline): Prescribed to adults who can’t take Augmentin.
• Trimethoprim-sulfamethoxazole: A combination therapy prescribed for certain types of pneumonia and to immunocompromised people such as those with HIV.
• Vibramycin (doxycycline): Prescribed to healthy adults under the age of 65, sometimes with amoxicillin.
• Xenleta (lefamulin): Prescribed to adults who can’t take Augmentin.
• Zithromax (azithromycin): Prescribed to healthy adults under the age of 65, often in combination with amoxicillin.

Getting vaccinated can help tobacco users prevent pneumonia.

Hospitalized Adults

Adults who are hospitalized require treatment with different antibiotics. Your healthcare provider will choose an antibiotic depending on whether you are infected with methicillin-resistant Staphylococcus aureus (MRSA), a bacteria called Pseudomonas, or something else. These antibiotics include:

• Antipseudomonal beta-lactam plus an antipseudomonal fluoroquinolone: Prescribed to hospitalized adults with Pseudomonas and those who have recently received intravenous (IV) antibiotics.
• Beta-lactam plus macrolide: A combination therapy prescribed for hospitalized adults who have neither MRSA nor Pseudomonas.
• Beta-lactam plus Vibramycin (doxycycline): A combination therapy prescribed for hospitalized adults who have neither MRSA nor Pseudomonas.
• Inhaled fluoroquinolone (levofloxacin, gemifloxacin): Prescribed for hospitalized adults who have neither MRSA nor Pseudomonas.
• Rocephin (ceftriaxone): A first-line treatment for hospitalized adults with community-acquired pneumonia.
• Vabomere (Meropenem-vaborbactam): Used to treat severe pneumonia, including hospital-acquired pneumonia and ventilator-associated pneumonia
• Vancocin (vancomycin): Prescribed to hospitalized adults who have, previously had, or are suspected of having MRSA.
• Zyvox (linezolid): Prescribed to hospitalized adults who have, previously had, or are suspected of having MRSA.

Children With Pneumonia

Antibiotics can also be used to treat children with pneumonia:

• Aminoglycoside: Prescribed to newborns with pneumonia.
• Amoxil (amoxicillin) and other beta-lactam antibiotics: Prescribed to infants and children older than 3 months.
• Ampicillin: Prescribed to newborns with pneumonia.
• Zithromax (azithromycin): A first-line treatment for children older than 5 years.
• Third-generation cephalosporins: Prescribed to newborns with pneumonia.
• Clarithromycin: A first-line treatment for children older than 5 years. Also prescribed to infants between the ages of 1 and 3 months who have atypical pneumonia.
• Cleocin (clindamycin): Prescribed to children with MRSA.
• Erythrocin (erythromycin): A first-line treatment for children older than 5 years. Also prescribed to infants between the ages of 1 and 3 months who have atypical pneumonia.
• Vancocin (vancomycin): Prescribed to children with MRSA.

Children with other illnesses may need antibiotics like:

• Claforan (cefotaxime)
• Vancocin (vancomycin)
• Macrolides
• Piperacillin

Children under 90 days old, immunocompromised children, and children with underlying chronic conditions, like sickle cell anemia or cystic fibrosis, may need to be hospitalized.

Factors Determining Antibiotic Choice

Multiple types of antibiotics 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 most significant risk from pneumonia

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

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

• Your age: People 65 and older have a greater risk of severe 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 healthcare provider 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: Tell your healthcare provider if you are allergic to any medications, had bad reactions to antibiotics, 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.

How to Take Antibiotics for Pneumonia

A course of antibiotics for uncomplicated pneumonia treatment usually lasts five to seven days. Uncomplicated pneumonia means it is not in a hospitalized person, is not Pseudomonas, and does not have complications like effusion or respiratory failure.

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 healthcare provider to ensure your infection is cleared.

You’ll likely start to feel better and have some symptom relief one to three days after your pneumonia treatment, but it may take a week or more for your symptoms to go away completely.

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.

If you’re experiencing diarrhea while taking an antibiotic, consider taking a probiotic to support your microbiome.

Side Effects

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

• 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

Tell your healthcare provider if you are experiencing any side effects. Some side effects can be severe and life-threatening.

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.

Managing Symptoms

In addition to taking medication, you may be able to find some symptom relief using home remedies for pneumonia.

One of the best things to do is to stay hydrated. Chicken broth, electrolyte-enhanced beverages, and warm tea can be beneficial. Cough symptoms can be managed by gargling saltwater or adding honey to your tea. Sleeping on your stomach and using a humidifier can help ease difficulty breathing.

Avoid drinking alcohol, smoking, and breathing secondhand smoke when you have pneumonia.

Summary

Antibiotics are used to treat bacterial (and some fungal) types of pneumonia. The prescribed antibiotic is based on the type of pneumonia, age, health history, and more. Some first-line antibiotics for treating pneumonia include Zithromax (azithromycin), clarithromycin, and Erythrocin (erythromycin).

You will often take the antibiotics for five to seven days. Completing the entire course is essential. Side effects may occur, which you should report to your healthcare provider.