How pneumonia is treated?

Pneumonia – causes, symptoms, treatment

Pneumonia is a bacterial or viral infection of the lungs. Symptoms can include fever, chills, shortness of breath, coughing that produces phlegm, and chest pain. Pneumonia can usually be treated at home with antibiotics but some cases may require time in hospital and can result in death. Vaccines are available against some of the more common infectious agents that cause pneumonia.


Pneumonia is an infection of the air sacs in the lungs and is caused by bacteria, viruses or, rarely, fungi. Most cases of pneumonia are caused by bacteria, usually Streptococcus pneumonia (pneumococcal disease) but viral pneumonia is more common in children. The lungs are made up of separate lobes – three in the right lung and two in the left lung. Pneumonia may affect only one lobe or be widespread in the lungs. Anyone can develop pneumonia but some groups are at greater risk:

  • Babies and toddlers – particularly those born prematurely
  • People who have had a recent viral infection – such as a cold or influenza (the flu)
  • Smokers
  • People with chronic lung conditions such as asthma, bronchitis or bronchiectasis
  • People with suppressed or weak immune systems
  • People who have poor diets or are undernourished
  • People who drink excessive alcohol
  • Patients in hospital
  • People who have had swallowing or coughing problems following a stroke, concussion or other brain injury
  • People aged 65 years or older.

Pneumonia can develop when a person breathes in small droplets that contain pneumonia-causing organisms. It can also occur when bacteria or viruses that are normally present in the mouth, nose and throat enter the lungs.

Signs and symptoms

Viral pneumonia tends to develop slowly over a number of days, whereas bacterial pneumonia usually develops quickly, often over a day. Most people who develop pneumonia initially have a viral infection such as a cold or flu, which produces symptoms such as headache, muscle aches and fever. If pneumonia develops, symptoms commonly include:

  • Fever
  • Chills
  • Shortness of breath
  • Rapid breathing
  • A worsening cough that may produce yellow/green or bloody mucus (phlegm)
  • Chest pain when breathing or coughing – caused by inflammation of the membrane that lines the lungs.

In babies and children, symptoms may be less specific and they may not show clear signs of a chest infection. Commonly they will have a fever, appear unwell, and become lethargic. They may also have noisy or rattly breathing, have difficulty with feeding and make a grunting sound with breathing. People older than age 65 years with pneumonia may show signs of confusion or reduced mental awareness. It is also possible for the skin, lips and nail beds to become dusky or bluish. This is a sign that the lungs are unable to deliver enough oxygen to the body. If this occurs it is vital to seek medical assistance straight away.


If pneumonia is suspected it is important to seek medical attention promptly so that an accurate diagnosis can be made and appropriate treatment given. The doctor will take a medical history and will conduct a physical examination. During the examination the doctor will listen to the chest with a stethoscope. Coarse breathing, crackling sounds, wheezing and reduced breath sounds in a particular part of the lungs can indicate pneumonia. A chest x-ray is usually taken to confirm the diagnosis; it will show the areas of the lung affected by the pneumonia. Blood tests may also be taken and a sample of the sputum may be sent to the laboratory for testing.


Most cases of pneumonia can be treated at home. However, babies, children, and people with severe pneumonia may need to be admitted to hospital for treatment. Pneumonia is usually treated with antibiotics, even if viral pneumonia is suspected as there may be a degree of bacterial infection as well. The type of antibiotic used and the way it is given will be determined by the severity and cause of the pneumonia. Home-based treatment usually includes:

  • Antibiotics – given by mouth as tablets or liquid
  • Pain-relieving medications
  • Paracetamol to reduce fever
  • Drinking plenty of fluids, especially water, to help loosen mucus in the lungs
  • Rest.

Hospital-based treatment usually includes:

  • Antibiotics given intravenously (via a drip into a vein)
  • Oxygen therapy – to ensure the body gets the oxygen it needs
  • Intravenous fluids – to correct dehydration or if the person is too unwell to eat or drink
  • Physiotherapy – to help clear the sputum from the lungs.


Pneumonia may take several weeks to fully recover from. The cough may continue until the mucus has been cleared from the lungs. This is a part of the recovery process. Fatigue and a reduced ability to exercise may also be experienced. If the cough gets worse or recovery is taking longer than several weeks, see a doctor for further assessment. Smokers should have a chest x-ray after six weeks to confirm complete clearance of the lungs.


The following steps can be taken to reduce the risk of contracting pneumonia:

  • Breastfeeding your baby (preferably beyond four months) – to help boost their immune system
  • Quit smoking and ensure a smoke-free household
  • Keeping your home warm and well-ventilated
  • Vaccination, in particular against pneumococcal disease, whooping cough , Hib (Haemophilus influenza type b), and influenza
  • Regular and thorough hand-washing
  • Avoiding contact with people who have colds, the flu, or other infections.

Vaccines against pneumococcal disease may not always prevent pneumonia but they may prevent serious complications of pneumonia should infection occur.

Further information and support

For further information and advice about pneumonia contact your GP, practice nurse, or call:
Healthline Freephone: 0800 611 116 (operates 24 hours a day, 7 days a week)
Plunketline Freephone: 0800 933 922 (operates 24 hours a day, 7 days a week) Immunisation Advisory Centre Freephone: 0800 IMMUNE (0800 466 863) Kidshealth (2017). Pneumonia (Web Page). Wellington: Paediatric Society of New Zealand. Auckland: Starship Foundation.
Mayo Clinic (2018). Pneumonia (Web Page). Rochester, NY: Mayo Foundation for Medical Education and Research. National Heart, Lung, and Blood Institute (Year not stated). Pneumonia (Web Page). Bethesda, MD: National Institute of Health.
O’Toole, M.T. (Ed.) (2017). Pneumonia. Mosby’s Dictionary of Medicine, Nursing & Health Professions (10th ed.). St Louis, MI: Elsevier.

Last Reviewed – May 2019

Pneumonia: Prevention

Are vaccines available to prevent pneumonia?

Yes, there are two types of vaccines (shots) specifically approved to prevent pneumonia caused by pneumococcal bacteria. Similar to a flu shot, these vaccines won’t protect against all types of pneumonia, but if you do come down with pneumonia, it’s less likely to be as severe or potentially life-threatening – especially for people who are at increased risk for pneumonia.

  • Bacterial pneumonia: Two pneumonia vaccines, Pneumovax23® and Prevnar13®, protect against the most common causes of bacterial pneumonia.
    • Pneumovax23® protects against 23 different types of pneumococcal bacteria. It is recommended for all adults 65 years of age and older and children over 2 years of age who are at increased risk for pneumonia.
    • Prevnar13® protects against 13 types of pneumonia bacteria. It is recommended for all adults 65 years of age and older and children under 2 years of age. Ask your healthcare provider about these vaccines.
  • Viral pneumonia: Get a flu vaccine (shot) once every year. Flu vaccines are prepared to protect against that year’s virus strain. Having the flu can make it easier to get bacterial pneumonia.

If you have children, ask their doctor about other vaccines they should get. Several childhood vaccines help prevent infections caused by the bacteria and viruses that can lead to pneumonia.

Besides vaccination, what else can I do to prevent bacterial and viral pneumonia?

Receiving all recommended vaccinations is one of the best ways to prevent pneumonia. Additionally, there are several other ways to prevent pneumonia, including:

  • Quitting smoking, and avoiding secondhand smoke. Smoking damages your lungs.
  • Washing your hands before eating, before handling food, after using the restroom, and after being outside. If soap is not available, use an alcohol-based hand sanitizer.
  • Avoiding being around people who are sick. Ask them to visit when they are feeling better.
  • Not touching or sharing objects that are shared with others. Germs can be transferred from object to you if you touch your nose or mouth without washing or sanitizing your hands first.
  • Eating a healthy diet, exercise, and get enough rest. Healthy habits keep your immune system strong.
  • Getting treated for any other infections or health conditions you may have. These conditions could weaken your immune system, which could increase your chance of infections.
  • Avoiding excessive consumption of alcohol.

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Treatment at home

Visit your GP if your symptoms do not improve within 3 days of starting antibiotics.

Symptoms may not improve if:

  • the bacteria causing the infection is resistant to antibiotics – a GP may prescribe a different antibiotic, or they may prescribe a second antibiotic for you to take with the first one
  • a virus is causing the infection, rather than bacteria – antibiotics have no effect on viruses, and your body’s immune system will have to fight the viral infection by creating antibodies

Painkillers, such as paracetamol or ibuprofen, may help relieve pain and reduce fever.

However, you should not take ibuprofen if you:

  • are allergic to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)
  • have asthma, kidney disease, a history of stomach ulcers or indigestion

Cough medicines are not recommended as there is little evidence they are effective. A warm honey and lemon drink can help relieve discomfort caused by coughing.

Your cough may persist for 2 to 3 weeks after you finish your course of antibiotics, and you may feel tired for even longer as your body continues to recover.

Drink plenty of fluids to avoid dehydration, and get plenty of rest to help your body recover.

If you smoke, it’s more important than ever to stop, as smoking damages your lungs.

Read more about stop smoking treatments and how to stop smoking.

See a GP if, after following these self-help measures, your condition is deteriorating or is not improving as expected.

Pneumonia is commonly caused by viruses or bacteria passed from one person to another. But healthy people are normally able to fight off these germs without pneumonia developing. So it’s usually safe for someone with pneumonia to be around others, including family members.

However, people with a weakened immune system are less able to fight off infections, so it’s best they avoid close contact with a person with pneumonia.


The GP will probably arrange a follow-up appointment for you about 6 weeks after you start your course of antibiotics.

In some cases, they may arrange follow-up tests, such as a chest X-ray, if:

  • your symptoms have not improved
  • your symptoms have come back
  • you smoke
  • you’re over the age of 50

Some people may be advised to have a flu vaccination or pneumococcal vaccination after recovering from pneumonia.

Pneumonia: Management and Treatment

How is pneumonia treated?

How pneumonia is treated depends on the germs that cause it.

  • Bacterial pneumonia: Bacterial pneumonia is usually treated with antibiotics. The specific antibiotic choice depends on such factors as your general health, other health conditions you may have, the type of medications you are currently taking (if any), your recent (if any) use of antibiotics, any evidence of antibiotic resistance in the local community and your age. Medicines to relieve pain and lower fever may also be helpful. Ask your doctor if you should take a cough suppressant. It’s important to be able to cough to clear your lungs.
  • Viral pneumonia: Antibiotics are not used to fight viruses. (In some cases antibiotics may be given to fight a bacterial infection that is also present.) There are no treatments for most viral causes of pneumonia. However, if the flu virus is thought to be the cause, antiviral drugs might be prescribed, such as oseltamivir (Tamiflu®), zanamivir (Relenza®), or peramivir (Rapivab®), to decrease the length and severity of the illness. Over-the-counter medicines to relieve pain and lower fever are usually recommended. Other medicines and therapies such as breathing treatments and exercises to loosen mucus may be prescribed by your doctor.
  • Fungal pneumonia: Antifungal medication is prescribed if a fungus is the cause of your pneumonia.

How soon after treatment for pneumonia will I begin to feel better?

How soon you will feel better depends on several factors, including:

  • Your age
  • The cause of your pneumonia
  • The severity of your pneumonia
  • If you have other “at-risk” conditions

If you are generally healthy, most symptoms of bacterial pneumonia usually begin to improve within 24 to 48 hours after starting treatment. Symptoms of viral pneumonia usually begin to improve within a few days after starting treatment. A cough can last for several weeks. Most people report being tired for about a month after contracting pneumonia.

When would I need to be hospitalized for pneumonia?

If your case of pneumonia is more severe, you may need to stay in the hospital for treatment. Hospital treatments may include:

  • Oxygen
  • Fluids, antibiotics and other medicines given through an IV (directly into the vein)
  • Breathing treatments and exercises to help loosen mucus

People most likely to be hospitalized are those who are most frail and/or at increased risk, including:

  • Babies and young children
  • People over age 65
  • People with weakened immune systems
  • People with health conditions that affect the heart and lungs

It may take six to eight weeks to return to a normal level of functioning and well-being if you’ve been hospitalized with pneumonia.

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Pneumonia in Children

What is pneumonia in children?

Pneumonia is an infection in the lungs. It can be mild or serious. Pneumonia is generally more common in children younger than 5 years old.

What causes pneumonia in a child?

Pneumonia is most often caused by bacteria or viruses. Some of these bacteria and viruses can be spread by direct contact with a person who is already infected with them.

Common bacteria and viruses that may cause pneumonia are:

  • Streptococcus pneumoniae

  • Mycoplasma pneumonia. This often causes a mild form of the illness called walking pneumonia.

  • Group B streptococcus

  • Staphylococcus aureus

  • Respiratory syncytial virus (RSV). This is most often seen in children younger than 5 years old.

  • Parainfluenza virus

  • Influenza virus

  • Adenovirus

Pneumonia may sometimes be caused by fungi.

Which children are at risk for pneumonia?

A child is more likely to get pneumonia if he or she has:

  • Weak immune system, such as from cancer

  • Ongoing (chronic) health problem, such as asthma or cystic fibrosis

  • Problems with the lungs or airways

In addition, children younger than 1 year old are at risk if they are around secondhand tobacco smoke. This is especially true if their mother smokes.

What are the symptoms of pneumonia in a child?

Symptoms may be a bit different for each child. They may also depend on what is causing the pneumonia. Cases of bacterial pneumonia tend to happen suddenly with these symptoms:

  • Cough that produces mucus

  • Cough pain

  • Vomiting or diarrhea

  • Loss of appetite

  • Tiredness (fatigue)

  • Fever

Early symptoms of viral pneumonia are the same as those of bacterial pneumonia. But with viral pneumonia, the breathing problems happen slowly. Your child may wheeze and the cough may get worse. Viral pneumonia may make a child more at risk for bacterial pneumonia.

In addition to the symptoms listed above, your child may have:

  • Chills

  • Fast or hard breathing

  • Headache

  • Fussiness

The symptoms of pneumonia may look like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is pneumonia diagnosed in a child?

Your child’s healthcare provider can often diagnose pneumonia with a full health history and physical exam. He or she may include these tests to confirm the diagnosis:

  • Chest X-ray. This test makes images of internal tissues, bones, and organs.

  • Blood tests. A blood count looks for signs of an infection. An arterial blood gas test looks at the amount of carbon dioxide and oxygen in the blood.

  • Sputum culture. This test is done on the mucus (sputum) that is coughed up from the lungs and into the mouth. It can find out if your child has an infection. It’s not routinely done because it is hard to get sputum samples from children.

  • Pulse oximetry. An oximeter is a small machine that measures the amount of oxygen in the blood. To get this measurement, the provider tapes a small sensor onto a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.

  • Chest CT scan. This test takes images of the structures in the chest. It is very rarely done.

  • Bronchoscopy. This procedure is used to look inside the airways of the lungs. It is very rarely done.

  • Pleural fluid culture. This test takes a sample of fluid from the space between the lungs and chest wall (pleural space). Fluid may collect in that area because of the pneumonia. This fluid may be infected with the same bacteria as the lung. Or the fluid may just be caused by the inflammation in the lung.

How is pneumonia treated in a child?

Treatment may include antibiotics for bacterial pneumonia. No good treatment is available for most viral pneumonias. They often get better on their own. Flu-related pneumonia may be treated with an antiviral medicine.

Other treatments can ease symptoms. They may include:

  • Plenty of rest

  • Getting more fluids

  • Cool mist humidifier in your child’s room

  • Acetaminophen for fever and discomfort

  • Medicine for cough

Some children may be treated in the hospital if they are having severe breathing problems. While in the hospital, treatment may include:

  • Antibiotics by IV (intravenous) or by mouth (oral) for bacterial infection

  • IV fluids if your child is unable to drink well

  • Oxygen therapy

  • Frequent suctioning of your child’s nose and mouth to help get rid of thick mucus

  • Breathing treatments, as ordered by your child’s healthcare provider

What are possible complications of pneumonia in a child?

Pneumonia can be a life-threating illness. It may have these complications:

  • Severe breathing problems

  • Bacteria that enters the blood

How can I help prevent pneumonia in my child?

Pneumococcal pneumonia can be prevented with a vaccine that protects against 13 types of pneumococcal pneumonia. Doctors recommend that children get a series of shots beginning at age 2 months. Talk with your child’s healthcare provider about this vaccine. Another vaccine is available for children older than 2 years who are at increased risk for pneumonia. Talk with your child’s healthcare to see if it is recommended for your child. Also make sure your child is up-to-date on all vaccines, including the yearly flu shot. Pneumonia can occur after illnesses such as whooping cough and the flu.

You can also help your child prevent pneumonia with good hygiene. Teach your child to cover their nose and mouth when coughing or sneezing. Your child should also wash their hands often. These measures can help prevent other infections, too.

Your child can be vaccinated against pneumococcal pneumonia. There are 2 types of vaccines that can help prevent pneumococcal disease. The vaccine that is right for your child depends on their age and risk factors. Talk with your child’s healthcare provider about which vaccine is best for your child and when they should get it.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child’s symptoms get worse. Or if he or she has:

  • A fever for more than a few days

  • Breathing problems

  • New symptoms, such as neck stiffness or swollen joints

  • Trouble drinking enough fluids to stay well hydrated

Key points about pneumonia in children

  • Pneumonia is an infection in the lungs. It can be mild or serious.

  • The illness can be caused by bacteria, viruses, and fungi.

  • Some common symptoms include fever, cough, tiredness (fatigue), and chest pain.

  • Treatment depends on the cause of the pneumonia.

  • Some types of pneumonia can be prevented with a vaccine. Good handwashing and hygiene can also help.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

  • Ask if your child’s condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if your child does not take the medicine or have the test or procedure.

  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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