Pneumonia treatment depends on the cause of the illness. Because of practical difficulties in obtaining adequate phlegm samples and the delays in getting back the results, antibiotic treatment is often started immediately, based on the physician’s suspicions of the most likely cause.
Whether someone with pneumonia needs to be hospitalized depends on the severity of the pneumonia, the individual’s overall health status, and whether family members and other caregivers are able to take care of the person at home.
Antibiotics are the mainstay of treatment for bacterial pneumonia (as well as for some other types, such as mycoplasma pneumonia). The sooner treatment is started, the better.
The antibiotic of choice depends on the type of bacterium responsible for the pneumonia. At one time, penicillin was highly effective against Streptococcus pneumoniae. Penicillin-resistant strains have become more common, however, and newer antibiotics may be needed to treat highly resistant strains.
Mycoplasmas and other less common microorganisms may be the cause of the pneumonia (and the resulting symptoms may overlap with those of pneumonia caused by Streptococcus pneumoniae). Therefore, combinations of antibiotics are generally prescribed. An early switch from intravenous to oral antibiotics (as symptoms improve) has been found to be safe and effective for people who have been hospitalized with bacterial pneumonia, allowing them to go home sooner.
When antibiotics don't work
Antibiotics are not effective against viral pneumonia. Most people with viral pneumonia recover without treatment in one to three weeks. Humidified air, supplemental oxygen, and increased fluids may be advised.
Typically, symptoms improve rapidly after pneumonia treatment begins, but the speed of recovery depends on the individual’s previous health status. People usually notice symptom improvement before their doctors begin to see changes on chest X-rays. This is especially true for older people who have multilobar pneumonia, COPD, or alcoholism.