Treatment:

If the cause is bacterial, the doctor will try to cure the infection with antibiotics. If the cause is viral, typical antibiotics will NOT be effective. Sometimes, however, your doctor may use antiviral medication. It may be difficult to distinguish between viral and bacterial pneumonia, so you may receive antibiotics.

Patients with mild pneumonia who are otherwise healthy are usually treated with oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin).

Patients with other serious illnesses, such as heart disease, chronic obstructive pulmonary disease, or emphysema, kidney disease, or diabetes are often given one of the following:

• Fluoroquinolone (levofloxacin (Levaquin), sparfloxacin (Zagam), or gemifloxacin (Factive), moxifloxacin (Avelox)
• High-dose amoxicillin or amoxicillin-clavulanate, plus a macrolide antibiotic (azithromycin, clarithromycin, or erythromycin)

Many people can be treated at home with antibiotics. If you have an underlying chronic disease, severe symptoms, or low oxygen levels, you will likely require hospitalization for intravenous antibiotics and oxygen therapy. Infants and the elderly are more commonly admitted for treatment of pneumonia.

You can take these steps at home:

• Drink plenty of fluids to help loosen secretions and bring up phlegm.
• Get lots of rest. Have someone else do household chores.
• Control your fever with aspirin or acetaminophen. DO NOT give aspirin to children.

When in the hospital, respiratory treatments to remove secretions may be necessary. Occasionally, steroid medications may be used to reduce wheezing if there is an underlying lung disease.

Expectations (prognosis):

With treatment, most patients will improve within 2 weeks. Elderly or debilitated patients may need treatment for longer.

Your doctor will want to make sure your chest x-ray becomes normal again after you take a course of antibiotics.

Complications:

Empyema or lung abscesses are infrequent, but serious, complications of pneumonia. They occur when pockets of pus form around or inside the lung. These may sometimes require surgical drainage.

Calling your health care provider:

Call your doctor if you have:

• Worsening respiratory symptoms
• Shortness of breath, shaking chills, or persistent fevers
• Rapid or painful breathing
• A cough that brings up bloody or rust-colored mucus
• Chest pain that worsens when you cough or inhale
• Night sweats or unexplained weight loss
• Signs of pneumonia and weak immune system, as with HIV or chemotherapy

Infants with pneumonia may not have a cough. Call your doctor if your infant makes grunting noises or the area below the rib cage is retracting while breathing.