Patient information from BMJ

Pneumonia

Last published:Feb 01, 2022

Pneumonia is caused by an infection in your lungs. It can be serious, so it's important to get treatment quickly.

We've brought together the best and most up-to-date research about pneumonia to see what treatments work. You can use our information to talk to your doctor and decide which treatments are best for you.

What is pneumonia?

Pneumonia is usually caused by an infection with bacteria or a virus. The infection causes inflammation (swelling) in your lungs. Parts of your lungs can then clog up with fluid, making it harder for you to breathe.

What are the symptoms?

Pneumonia is serious and can make you feel very ill.

• Many people have a fever and a cough.

• You may feel as if you can't catch your breath.

• You'll be weak and tired and just generally feel ill. Older people with pneumonia sometimes feel confused.

• You probably won't feel like eating or drinking.

Some people get chest pain as they breathe in or out. This can happen if you get inflammation between the layers of tissue that cover your lungs. This stops your lungs moving smoothly as you breathe. It's called pleurisy.

Having pneumonia can sometimes make it hard to breathe in enough oxygen. This is very dangerous. If you get a bluish tinge to your lips or the skin under your fingernails, call an ambulance right away.

You should also get emergency help if you feel confused, or if another person notices that you are confused, they might call for help. Confusion is another sign that you're not getting enough oxygen.

Your doctor might suggest a chest x-ray to help find out what's causing your symptoms.

What treatments work?

If you have pneumonia that's caused by bacteria you'll need treatment with antibiotics as soon as possible. Antibiotics are drugs that kill bacteria. Bacteria are the most common cause of pneumonia.

You'll probably take your antibiotics at home as tablets. But if for some reason you can't take tablets, or if your symptoms are severe, you'll be given antibiotics as a drip.

If you don't start to feel better within three days of starting treatment, tell your doctor (he or she should have arranged a follow-up with you to check if you're improving). You may need to try a different type of antibiotic.

It's very important that you finish taking your tablets. You need to do this even if you start feeling better. If you don't finish your treatment, some bacteria may not be killed. They can start to grow in your lungs again and your pneumonia could come back and be more difficult to treat.

Antibiotics can have side effects. The most common are nausea (feeling sick), vomiting, or diarrhoea. Some people get a rash. This happens because of a mild allergic reaction. It's not serious, but you should let your doctor know about it.

It's also possible to have a more serious allergic reaction. Tell your doctor if you're allergic to any antibiotics: for example, some people are allergic to penicillin.

Antibiotics will not work if your pneumonia is caused by a virus. But you may need them if you get a bacterial infection in addition to an infection caused by a virus. Viral pneumonia usually clears up by itself.

Getting out of bed and moving around a little each day can help you get better. This is because it exercises your lungs. But don't do too much.

Will I need to go to hospital?

Most people with pneumonia recover at home. But some people need to be treated in hospital. For example, your doctor may think you need hospital treatment if you're older or if you have other medical conditions or a more serious case of pneumonia.

In hospital, as well as antibiotics, you'll probably be given fluids through a drip in your arm. This will stop you getting dehydrated if you are too ill to drink. You'll also have your temperature and breathing checked regularly.

You might also be given a short course of steroids (their full name is corticosteroids). These are drugs that help reduce the swelling in your lungs.

If you're treated in hospital, getting out of bed and moving around for a few minutes a day may help you go home sooner. You may also be able to go home sooner if you exercise your lungs. You can do this by breathing deeply or blowing through a tube into a bottle of water.

Ask your doctor about how much you should be moving around, and whether breathing exercises could help you.

Taking care of yourself

Pneumonia needs to be taken seriously even if you are young and fit. You need to take good care of yourself. There are some simple things you can do to help your recovery.

• Get plenty of rest. You can start to do more as you feel better, but don't push yourself. Don't do anything that you don't feel well enough to do. If you're resting in bed, turn over at least every hour while you're awake. Breathe deeply five to 10 times and then cough strongly a couple of times. This helps to clear any phlegm that's settled in your lungs.

• If you have a fever or are in pain you can take an over-the-counter painkiller such as paracetamol or ibuprofen. Make sure you take them according to the instructions on the packet. Taking too much can be dangerous.

• Drink plenty of fluids so that you don't get dehydrated.

• If you're a smoker, now is a good time to give up. Smoking damages your lungs and makes it more likely that you'll get pneumonia again. Your doctor can help you with ways to stop smoking.

What will happen to me?

Pneumonia is serious and can sometimes be life threatening. But with prompt treatment most people are completely cured.

If you have pneumonia that's caused by bacteria there's a good chance that antibiotics will kill the bacteria and get rid of the infection.

But antibiotics don't work on viruses. Most of the time pneumonia that's caused by a virus will get better without treatment.

How long it takes to get better depends on several things, including your age and general health. If you're young and in good health, you'll probably get better sooner.

If you get treated quickly you should start to feel better in a few days. However, it will take some time for you to feel as well as you did before you had pneumonia. If you are older or have another condition that affects your health, it can take several months before you feel as if you've made a complete recovery.

Your doctor might order a chest x-ray to make sure your pneumonia has cleared up, especially if you're over 50 or if you smoke.