Bacterial pneumonia is treated using drugs called antibiotics. There are typically three classes, or groups, or antibiotics healthcare providers will use when treating bacterial pneumonia:
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Beta-lactams: Recommended drugs in this class include high-dose amoxicillin (Amoxil), amoxicillin-clavulanate (Augmentin), cefpodoxime (Vantin), and cefuroxime (Ceftin).
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Macrolides: The two preferred macrolides are clarithromycin (Biaxin) and azithromycin (Zithromax). Macrolides are believed to effectively treat a large number of bacteria known to cause respiratory infections and pneumonia.
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Tetracyclines: The recommended drug in this class is doxycycline (Oracea, Monodox).
- Fluoroquinolones: Recommended drugs in this class include levofloxacin (Levaquin), moxifloxacin (Avelox), or gemifloxacin (Factive).
Combining antibiotics is recommended, preferably a beta-lactam combined with a macrolide. Doxycycline may be used in place of a macrolide. For people who are allergic to penicillin or who have received a beta-lactam within the prior three months, a fluoroquinalone may be used.
In rarer cases, pneumonia may sometimes be caused by less common strains of bacteria. For people who are suspected to have infection with Pseudomona aeruginosa, a different combination of drugs is preferred. For the beta lactam, the drugs peracillin-tazobactam (Zosyn), cefepime, imipenem or meropenem are recommended, in combination with either ciprofloxacin (Cipro) or levofloxacin (Levaquin).
When methicillin-resistant Staphylococcus aureus (MRSA)—a potentially dangerous drug-resistant infection—is suspected as the cause of the pneumonia, experts recommend that vancomycin, possibly combined with clindamycin (Cleocin) or linezolid (Zyvox), be added to regular antibiotic therapy.
Pneumonia sometimes requires treatment in a hospital, where oxygen and other medications can be administered to ensure effectiveness and to make the patient more comfortable.
Patients usually start feeling better within two to three days after treatment is started. However, completing the full course of treatment is necessary, to ensure that the infection is controlled and to prevent the infection from becoming resistant to the medications being used.
A syndrome—called immune reconstitution inflammatory syndrome (IRIS)—where antiretroviral treatment can actually exacerbate the symptoms of an opportunistic infection due to a strengthened immune response, has not been reported with bacterial pneumonia.
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