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Medications for Pneumonia

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Community-acquired pneumonia is most often treated with macrolides, such as clarithromycin, azithromycin, or doxycycline. It may also be treated with fluoroquinolones, such as levofloxacin, moxifloxacin, or gatifloxacin.

Hospital-acquired pneumonia may need to be treated with a combination of antibiotics if infected with multidrug-resistant bacteria.

Prescription Medication

Antibiotics in General

Antibiotics work by killing bacteria or preventing them from growing and reproducing. The choice of antibiotic depends on the type of bacteria that is believed to be causing the infection. The way the antibiotic is administered (oral or IV) depends on how ill you are and whether you have any other medical conditions that put you at risk for severe infection or complications.

You must take every dose of an antibiotic, even when you're feeling better.

Antibiotics may cause allergic reactions in susceptible people. You should discontinue your medication and immediately contact your doctor if you experience:

  • Skin rash
  • Hives
  • Itching
  • Puffy face
  • Puffiness around the eyes
  • Difficulty breathing

Many antibiotics interact with other medications. To avoid any dangerous or uncomfortable drug interactions, tell your doctor about all other medications you are using.

Beta-lactam Antibiotics

Common names include:

  • Amoxicillin
  • Amoxicillin-clavulanate
  • Piperacillin-tazobactam
  • Cephalexin
  • Cefadroxil
  • Cefaclor
  • Cefuroxime
  • Cefpodoxime
  • Loracarbef
  • Cefditoren
  • Cefixime
  • Ceftibuten
  • Cefepime
  • Meropenem
  • Imipenem/cilastatin

Possible side effects include:

  • Diarrhea—Contact your doctor if it is severe.
  • Nausea or vomiting.
  • Bleeding problems—You may notice easy bruising, increased bleeding, or spontaneous bleeding.
  • Some cephalosporins should not be taken with alcohol. Check with your doctor.
Fluoroquinolone Antibiotics

Common names include:

  • Ciprofloxacin
  • Levofloxacin
  • Gemifloxacin
  • Gatifloxacin
  • Moxifloxacin

If you are taking antacids or sucralfate, do not take them within 2 hours of taking a fluoroquinolone. Take these medications with a full glass of water. They may be taken either on an empty stomach or with meals. Check with doctor before taking some of the quinolones if you are taking any medication for your heartbeat.

Possible side effects include:

  • Increased sensitivity to the sun
  • Lightheadedness
  • Inflamed, torn tendons
Macrolides

Common names include:

  • Erythromycin
  • Azithromycin
  • Clarithromycin

Possible side effects include:

  • Stomach cramps
  • Nausea
  • Vomiting
  • Diarrhea
Tetracyclines

Common names include:

  • Tetracycline
  • Doxycycline
  • Minocycline

Always take these medications with a full glass of water.

Possible side effects include:

  • Stomach cramps, burning
  • Diarrhea
  • Nausea
  • Vomiting
  • Tetracycline can cause discolored teeth in children
  • When pregnant women take tetracycline, their children may have discolored teeth
  • Increased sensitivity to the sun
  • Lightheadedness
Trimethoprim-sulfamethoxazole

Common names include:

  • Co-trimoxazole
  • Bactrim
  • Septra

These medications are usually not prescribed for infants less than 2 months old. Elderly people have an increased risk of skin and bleeding problems with these medications, especially if they are using diuretics. Always take the medications with a full glass of water.

Possible side effects include:

  • Increased sensitivity to the sun
  • Itching
  • Skin rash
  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach upset
Aminoglycosides

Common names include:

  • Gentamicin
  • Kanamycin
  • Tobramycin
  • Amikacin

Aminoglycosides are usually given through an IV.

Because aminoglycosides can affect the kidneys, hearing, balance, and muscles, be sure to tell your doctor if you already have conditions that affect those body systems. Depending on your condition, a different antibiotic may be chosen.

Possible side effects include:

  • Kidney problems
  • Hearing problems
  • Balance problems
  • Muscle weakness, especially in those who already have conditions like Parkinson’s disease or myasthenia gravis
  • Nausea
  • Vomiting
  • Numbness, tingling, burning sensations in face and/or mouth
  • Seizures
  • Muscle twitches
Lincosamide

Common names include: Clindamycin

Possible side effects include:

  • Stomach cramps
  • Nausea
  • Vomiting
  • Diarrhea
  • Rash
  • Itching
Glycopeptides

Common names include Vancomycin

Glycopeptides are usually given through an IV.

These drugs can be hard on the kidneys and on hearing and balance. Tell your doctor if you already have conditions that affect those body systems.

Oxazolidinones

Common names include: Linezolid

Possible side effects include:

  • Drop in white blood cells, which can increase your risk of infection
  • Drop in platelets, which can increase your risk of:
    • Bleeding
    • Easy bruising
    • Slow healing
  • High blood pressure, especially when taken with aged cheeses, smoked foods, beer, wine, or soy sauce
Antiviral medication

Medications developed for the treatment of different types of viral pneumonia include:

Antifungal Medication

Common names include:

  • Amphotericin B
  • Fluconazole
  • Itraconazole
  • Voriconazole
  • Flucytosine

Antifungal medications are available to fight fungal pneumonias. You must take every dose of an antifungal. Even if you’re feeling better, be sure to complete the course of medication recommended by your doctor.

Antifungal medications may cause allergic reactions in susceptible individuals. You should discontinue your medication and immediately contact your doctor if you experience:

  • Skin rash
  • Hives
  • Itching
  • Puffy face
  • Puffiness around eyes
  • Difficulty breathing

Many antifungal medications interact with other medications. Make sure your doctor knows about all other medications you are using to avoid any dangerous or uncomfortable drug interactions. Be sure that your doctor knows about any other medical conditions you may have.

Possible side effects include:

  • Increased sensitivity to the sun
  • Fever
  • Chills
  • Skin rash
  • Itching
  • Diarrhea
  • Nausea
  • Vomiting

Over-the-Counter Medication

Acetaminophen

Common brand name includes: Tylenol

Acetaminophen can be helpful in relieving some of the fever and pain associated with pneumonia. It’s also safe to give to children. Do not take larger doses than is recommended by your doctor. Do not drink alcoholic beverages while you are taking acetaminophen. Excess acetaminophen can be toxic to your liver.

Ibuprofen

Common brand names include:

  • Motrin
  • Advil

Ibuprofen can also help relieve some of the fever and discomfort associated with pneumonia. Ibuprofen may irritate the stomach; you should take this medication with food. Drinking alcoholic beverages while you are taking ibuprofen can increase the chance that it will irritate your stomach.

On rare occasions, people have allergic reactions to ibuprofen. If you notice a new skin rash, difficulty breathing, or puffiness or swelling in your face or around your eyes, stop taking ibuprofen and immediately contact your doctor.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.

Revision Information

  • Bjerre LM, Verheij TJ, Kochen MM. Antibiotics for community acquired pneumonia in adult outpatients. Cochrane Database Syst Rev. 2004;(2):CD002109

  • Carratala J, Martin-Herrero JE, Mykietiuk A, García-Rey C. Clinical experience in the management of community-acquired pneumonia: lessons from the use of fluoroquinolones. Clin Microbiol Infect. 2006;12 Suppl 3:2-11

  • Community-acquired pneumonia in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115170/Community-acquired-pneumonia-in-adults. Updated August 15, 2016. Accessed November 10, 2016.

  • Community-acquired pneumonia in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113670/Community-acquired-pneumonia-in-children. Updated May 17, 2016. Accessed November 10, 2016.

  • Kabra SK, Lodha R, Pandey RM. Antibiotics for community acquired pneumonia in children. Cochrane Database Syst Rev. 2006;(3):CD004874

  • Schmidt-Ioanas M, Lode H. Treatment of pneumonia in elderly patients. Expert Opin Pharmacother. 2006;7(5):499-507

  • Treatment. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/pnu/treatment. Updated September 26, 2016. Accessed November 10, 2016.

  • 11/21/2007 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T115170/Community-acquired-pneumonia-in-adults: Yahar D, Paul M, Fraser A, Sarid N, Leibovi L. Efficacy and safety of cefepime: a systematic review and meta-analysis. Lancet Infect Dis. 2007;7(5):338-348.