Pneumonia

Your health expert: Dr Peter George, Consultant Respiratory Physician and Dr Amilia Alifrangis, Lead Physician, Bupa Health Clinics
Content editor review by Rachael Mayfield-Blake, Freelance Health Editor, August 2023
Next review due August 2026

Pneumonia is inflammation of the tissues in your lung and is usually caused by an infection. Most people recover well from pneumonia. But it can be a very serious condition and need medical attention – sometimes you may need to go to hospital to have pneumonia treatment.

Pneumonia causes

Pneumonia is usually caused by either a bacterial infection or a viral infection. The bacteria or virus can get into your lungs and cause the alveoli (tiny air sacs) and smaller airways to become inflamed and filled with fluid. This makes it harder for your lungs to work properly.

Anyone of any age can get pneumonia. But you’re at greater risk of getting pneumonia or getting it more severely if you:

are over 65 or under two years of age
smoke (smoking damages your lungs which makes you more prone to infection)
have long-term lung problems such as asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis or cystic fibrosis
have other health conditions such as diabetes or a heart, liver or kidney condition
regularly drink alcohol
have a weakened immune system (for example, if you have HIV/AIDS or are undergoing chemotherapy)

You’re also more likely to get pneumonia if you’re in hospital for other reasons. If you develop pneumonia while you’re in hospital, it’s called hospital-acquired pneumonia.

It’s also possible to get pneumonia from inhaling small amounts of liquid or material from your stomach or mouth and throat into your lungs. This can damage the lungs and cause infection. This is known as aspiration pneumonia. It’s more likely to happen if you’re unconscious or if you have a condition that causes swallowing difficulties.

Pneumonia symptoms

If you have pneumonia, you’ll probably feel unwell and have symptoms like flu.

Common symptoms of pneumonia include:

a cough – this may be dry or you may cough up sputum which can be green–yellow, rust-coloured or even bloodstained
a fever and you might also sweat and shiver
breathlessness
pain in your chest, which is worse when you take a deep breath (pleurisy)
loss of appetite
muscle aches and pains

Your symptoms may come on gradually, but sometimes the symptoms of pneumonia start suddenly and rapidly get worse.

Symptoms of pneumonia may vary depending on your age and other medical problems. An older person with pneumonia may just seem generally unwell and off their food. They may also be confused and more prone to falls. A young child with pneumonia may be restless and irritable, perhaps with abdominal (tummy) pain.

These symptoms aren't always caused by pneumonia, but if you have them and feel very unwell, contact your GP. If your symptoms are severe (for example, you’re feeling very short of breath or coughing up blood), seek urgent medical attention.

Diagnosis of pneumonia

Your GP will often be able to diagnose if you have pneumonia by asking about your symptoms and examining you. They might count how fast you’re breathing and listen to your chest to see how it sounds. They may use a stethoscope to check if they can hear any crackly noises in your lungs.

Your GP may also take your blood pressure, pulse rate and temperature. They may measure the amount of oxygen in your blood, using a device that clips to your finger. They might also ask you some questions to check if you’re struggling with any confusion.

Based on your age, symptoms and their examination, your GP will decide whether you should go to hospital or can be treated at home.

In some cases, you may also need other tests including:

a chest X-ray
a CT scan
blood tests
a mucus (sputum) sample to send to a laboratory for testing
a urine sample to test for bacteria²¹

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Self-help for pneumonia

If you have pneumonia, there are things you can do to help yourself while you recover. You should:

stop smoking
drink plenty of fluids – enough to keep hydrated
get plenty of rest

If you’re resting in bed, turn over at least once every hour while you’re awake. To help clear any phlegm that has settled in your lungs, breathe deeply five to 10 times, followed by a few strong coughs.

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 also take any prescribed medications as directed by your doctor.

Pneumonia treatment

Medicines

The main treatment for bacterial pneumonia is a course of antibiotics. Your GP will advise you to start this as soon as possible. A type of penicillin is often used to treat pneumonia, so it’s vital that you tell your GP if you’re allergic to penicillin. If you can’t have penicillin, there are other effective antibiotics that your GP can offer you instead.

You’ll usually need to take the antibiotics for five days to start with. If you’re not feeling better within three days after starting the antibiotics or you start feeling much worse, it’s important to tell your GP. They may ask you to take antibiotics for a few more days, prescribe a different antibiotic or arrange further tests or a specialist review.

If you have viral pneumonia, antibiotics won’t work because they act against bacteria not viruses. Viral pneumonia is mainly treated with supportive therapy as described in our self-help section. But there are some antiviral medicines your doctor may prescribe if you’re at high risk of complications.

Hospital treatment

If your symptoms are severe or you don’t get better at home with initial treatment, your GP may advise you to go to hospital.

In hospital, your doctor may recommend that you have two antibiotics rather than one. You may be given these directly into a vein with a drip (intravenously, IV). In some areas it may be possible for nurses to come to your house to give you IV antibiotics. Your GP will tell you if this is an option for you.

While you’re in hospital, your doctor will monitor how much oxygen your body is getting. You’ll probably be offered oxygen to help your breathing. If you have very severe pneumonia, you may need help with your breathing using a ventilator (an artificial breathing machine).

Recovering from pneumonia

Most people who have pneumonia recover well, but it can take weeks or months to feel completely back to normal. How quickly you get better depends on how severe your pneumonia was, your age and your general health. Most people can expect that by:

one week, your temperature should be back to normal
four weeks, you shouldn’t have much chest pain or produce as much sputum
six weeks, your cough will be much better and you won’t feel so breathless
three months, most of your symptoms will have gone but you may still frequently feel tired
six months, you’ll be back to normal

It’s important to see your GP if your symptoms get worse rather than better.

If you’re still experiencing symptoms after six weeks or you’re at higher risk (for example, you smoke), your doctor may suggest a follow-up X-ray. This is to make sure the infection has gone and to check for any complications.

If you’ve had pneumonia, you can get it again. If you do get pneumonia more than once, you might need to have some tests to see why. Your GP will refer you to see a specialist for these.

Complications of pneumonia

Most people with pneumonia recover well and return to good health. However, pneumonia can sometimes lead to complications. These include the following.

A build-up of fluid around your lungs is called a pleural effusion. This might make you feel breathless. It might go away on its own with antibiotic treatment but can sometimes need hospital treatment.
Severe breathing difficulties can develop as a result of severe inflammation in your lungs. You may need to go on a ventilator if your breathing is severely affected.
An abscess (collection of pus) in your lung might require treatment in hospital to drain it.
Septicaemia (blood poisoning) is an infection that can spread to other parts of your body and may be fatal if not treated straight away.

Prevention of pneumonia

If you smoke, stopping will reduce your risk of getting pneumonia. It will also reduce the chance of those around you (for example, your children) getting pneumonia. There’s a lot of advice available to help you quit – speak to your pharmacist or contact your GP surgery for advice.

Your GP may recommend you have a vaccination (jab) against pneumonia and flu if you’re at risk. There are two vaccines that can help prevent pneumonia caused by infection with a bacterium called Streptococcus pneumoniae.

Pneumococcal polysaccharide vaccine (PPV) is given to anyone aged over 65. It is also given to children over the age of two and at high risk. It protects against 23 strains of the bacterium.
Pneumococcal conjugate vaccine (PCV) is for children under the age of two. The first dose is given at around three months old and protects against 13 strains of the bacterium.

If you’re at risk, you can get vaccinated at your GP surgery. Vaccines are also available from private clinics and some pharmacists. You should also consider having a flu jab because pneumonia can develop as a complication of flu.

Antibiotics are the main treatment for bacterial pneumonia. A type of penicillin antibiotic is often used to treat pneumonia, so it’s important to tell your GP if you’re allergic to this. If you can’t have penicillin, you’ll be offered other antibiotics instead. If your symptoms are severe, your GP may send you to hospital.

For more information, see our section on treatment of pneumonia.

Atypical pneumonia is the name of a particular type of pneumonia that’s caused by something other than the bacteria that usually cause pneumonia. Even though this type of pneumonia is called atypical, it isn’t uncommon. Most people who get atypical pneumonia are young adults, especially when they live closely together.

The bacteria and viruses that cause pneumonia can be passed between people and are contagious. You can breathe these in if, for example, a person infected with the bacteria or virus coughs or sneezes near you.

It’s important to practice good hygiene while you have pneumonia to prevent giving it to others. Cover your mouth and nose when you cough or sneeze, and wash your hands.

For more information, see our section on causes of pneumonia.

Pneumonia can be a very serious condition. Some people need to go to hospital to be treated with antibiotics given directly into a vein with a drip. And you may be offered oxygen to help you breathe. If you have very severe pneumonia, you may need help with your breathing using a ventilator (an artificial breathing machine).

For more information, see our section on treatment of pneumonia.

The first signs of pneumonia often feel similar to having flu. You may get sore muscles and a fever. Other pneumonia symptoms can include a cough, and you may also feel breathlessness and get pain in your chest. The symptoms may come on gradually, but sometimes they start suddenly and rapidly get worse.

For more information, see our section on symptoms of pneumonia.

A person usually gets pneumonia from either a bacterial or a viral infection. You can get it in everyday life, which is known as community-acquired pneumonia. Or if you’re in hospital for something else, you can get what’s called hospital-acquired pneumonia. It’s also possible to get pneumonia from inhaling small amounts of liquid or material from your stomach or mouth and throat into your lungs. This is called aspiration pneumonia.

For more information, see our section on causes of pneumonia.

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