Pneumonia

Medications

Doctors use antibiotics to treat pneumonia caused by bacteria. Your doctor chooses an antibiotic after considering:

• Your age.
• Your symptoms.
• How severe your pneumonia is.
• Other medical problems you might have.
• What type of bacteria may be causing your pneumonia. Most cases of bacterial pneumonia in otherwise healthy people are caused by Streptococcus pneumoniae and Mycoplasma pneumoniae. Several other bacteria may cause pneumonia in the very young, older adults, and those with other diseases.
• Whether you may have a type of bacteria that some medicines can no longer kill (resistant bacteria).
• Whether you are allergic to any antibiotics.

Your doctor's choice of antibiotics may also depend on whether you:

• Are otherwise healthy and do not have to go to a hospital for treatment.
• Have other medical conditions but still do not have to go to the hospital.
• Have to go to the hospital.
• Have to go to an intensive care unit.

Medication Choices

Although experts differ on their recommendations, the first antibiotic used is usually one that kills a wide range of bacteria (broad-spectrum antibiotic). All antibiotics used have a high cure rate for pneumonia.⁶

If you do not have to go to the hospital, your doctor may use any of the following antibiotics:

• Macrolides, such as azithromycin, clarithromycin, and erythromycin.
• Tetracyclines, such as doxycycline.
• Fluoroquinolones, such as gemifloxacin, levofloxacin, and moxifloxacin.

If you have to go to the hospital, your doctor may use any of the above antibiotics. Other antibiotics that your doctor may use in this situation include:

• Cephalosporins, such as ceftriaxone, cefotaxime, ceftazidime, or cefepime.
• Penicillins, such as amoxicillin, amoxicillin with clavulanate, ampicillin, and ticarcillin with clavulanate.
• Vancomycin.

What To Think About

• In most cases of pneumonia, your doctor will prescribe antibiotics without first identifying the exact organism causing the illness.
• Your doctor may use two antibiotics when first starting your treatment.
• If you do not get better with the first choice of an antibiotic, you may have more testing to identify the specific organism that is causing the pneumonia. Your doctor also may add a second antibiotic to cover other bacteria that are not being treated with the first antibiotic.
• More and more bacteria are developing resistance to certain antibiotics, making them less effective. An example of this is MRSA, or methicillin-resistant staphylococcus aureus, which is resistant to many types of penicillin. To help fight antibiotic resistance, ask your doctor how to take your antibiotics correctly, such as always finishing your prescription.
• Doctors usually treat infants and children with macrolides, penicillin, or (if the child is older than age 8) doxycycline.¹⁰

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Author:	Ralph Poore	Last Updated: June 26, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Andrew Swan, MD, CCFP, FCFP - Family Medicine R. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care, Medical Toxicology
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