Antibiotics for Pneumonia: 8 Medications Your Doctor May Prescribe

Updated in January 2024

Antibiotics for pneumonia, such as amoxicillin + clavulanate, azithromycin, levofloxacin or vancomycin, may be prescribed by the doctor to help treat bacterial pneumonia. They can help relieve symptoms such as coughing, high-grade fever and difficulty breathing.

These antibiotics are often taken orally, however antibiotics may also be administered IV, particularly in people with HIV, older adults, children, or those who are hospitalized.

The use of antibiotics for pneumonia should be monitored by a doctor, who may also recommend other interventions, like respiratory physiotherapy, to help eliminate secretions and improve breathing.

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Medications for bacterial pneumonia

The main antibiotics for pneumonia that your doctor may consider include: 

1. Amoxicillin

Amoxicillin is an antibiotic from the penicillin class, which is generally the first-line treatment option for community-acquired bacterial pneumonia in adults or children who are not allergic to penicillins.

This antibiotic is capable of eliminating the most common bacteria that cause bacterial sinusitis, such as Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae, for example.

Amoxicillin can be found in the form of tablets, capsules or oral suspension.

In addition to amoxicillin, the doctor may also consider prescribing amoxicillin+clavulanate in people who are allergic or intolerant to macrolides, such as clarithromycin, azithromycin or erythromycin, for example.

2. Azithromycin

Azithromycin is an antibiotic from the macrolide class that is generally indicated for uncomplicated bacterial pneumonia. It combats most of the bacteria that cause bacterial pneumonia, including Legionella pneumophila and Mycoplasma pneumoniae.

Generally, the dose of azithromycin for the treatment of community-acquired bacterial pneumonia is a single dose of 500 mg once a day for 3 days, given IV.

Azithromycin can also be taken orally as tablets or oral suspension, at a dose of 500 mg, once a day, for 3 to 5 days.

3. Clarithromycin

Clarithromycin is another antibiotic from the macrolide class that works by eliminating bacteria that cause bacterial pneumonia, including bacteria in the Mycoplasma and Legionella species.

This antibiotic is typically taken orally, in tablet or suspension form, for 10 days.

4. Levofloxacin

Levofloxacin, like moxifloxacin and gatifloxacin, is a fluoroquinolone antibiotic indicated for the treatment of community-acquired bacterial pneumonia caused by several bacteria, including the penicillin-resistant Streptococcus pneumoniae bacteria.

This antibiotic is taken orally, and the normally recommended dose is one tablet of 500 mg or 750 mg as a single daily dose for 7 to 14 days.

5. Doxycycline

Doxycycline is an antibiotic from the tetracycline class that acts by impeding the metabolism of bacteria that cause bacterial pneumonia. This prevents their spread, and may be indicated for people who are allergic or intolerant to penicillins or macrolides.

This antibiotic can be found in tablet form and the doses normally recommended for adults are 100 mg, twice a day, or 200 mg once a day, as prescribed by a doctor.

6. Ceftriaxone

Ceftriaxone is an antibiotic from the cephalosporin class indicated for the treatment of community-acquired bacterial pneumonia. It is usually administed IV in a hospital setting.

The normally recommended dose for adults and children over 12 years of age is 1 to 2 g of ceftriaxone sodium in a single daily dose, that is, every 24 hours, for the duration of treatment established by the doctor.

Another antibiotic from the cephalosporin class that may be recommended by your doctor is cefuroxime.

7. Vancomycin

Vancomycin is another injectable antibiotic for the treatment of severe bacterial pneumonia, as it kills gram-positive bacteria that cause bacterial pneumonia, including methicillin-resistant Staphylococcus aureus.

This antibiotic is administered IV in the hospital setting. The recommended doses for adults are 2 g per day, divided into four doses of 500 mg every 6 hours, or 1 g every 12 hours. Duration is detemrined by the doctor depending on the severity of the infection. 

8. Meropenem

Meropenem, (as well as ertapenem and imipenem), are antibiotics from the carbapenem class. These are indicated for community-acquired bacterial pneumonia, caused by gram-positive or gram-negative bacteria, including multidrug-resistant Staphylococcus aureus.

These antibiotics are administered IV in a hospital setting. 

Other considerations

Other measures that patients should consider when taking antibiotics for pneumonia include resting, drinking plenty of water, and eating a healthy, balanced diet.

In some cases, the doctor may also prescribe corticosteroids or bronchodilators, as well as respiratory physiotherapy to prevent complications and promote a speedy recovery.

Antibiotics should be taken at the correct times and for the duration of treatment established by the doctor, even if the symptoms of pneumonia improve or resolve. This prevents bacterial resistance, which can make complicate treatment and worsen symptoms.

Bacterial pneumonia is not transmitted from person to person, so the patient does not need to be isolated from other people, but it is important to avoid contact with others to facilitate your own recovery.

Also recommended: Is Pneumonia Contagious? Why & 8 Ways to Preventtuasaude.com/en/is-pneumonia-contagious

Signs of improvement or worsening

Signs of improvement usually appear around 3 days after starting treatment with antibiotics. Patients will notice improvement in temperature, cough and phlegm, as well as improved breathing.

On the other hand, when treatment is not initiated soon after the onset of signs and symptoms, it is possible that symptoms may worsen. Worsening pneumonia will usually present with a persistent fever, a cough with phlegm, traces of blood in the phlegm, increased blood pressure, shortness of breath and difficulty breathing.

Worsening may be caused by other acquired infections in the body, or due to inappropriate antibiotic treatment. 

Possible complications

In some cases, bacterial pneumonia can worsen, causing cellular death of the lung tissue or accumulation of pus in the lungs. This requires treatment with other antibiotics, a lung puncture and/or the placement of a pulmonary drain to help eliminate secretions. 

Another possible complication that may occur is bacterial resistance to antibiotics, which can occur due to inappropriate use of antibiotics.