Pneumonia

Overview

Pneumonia is an infection of the lungs. The lungs are made of tiny air sacs (alveoli) that take oxygen into the blood. In pneumonia these sacs fill with pus and fluid, so breathing becomes painful and the body gets less oxygen. It is usually caused by bacteria or viruses, and less often by fungi. It can follow flu, RSV or COVID-19, and it can also happen when food or drink goes down into the lungs (aspiration pneumonia).

Pneumonia can affect anyone, from mild illness to life-threatening disease. Babies and children under 5, adults over 65, and people with heart or lung disease, diabetes or a weak immune system are most at risk of serious illness. Worldwide, pneumonia is the biggest infectious cause of death in young children, and most of these deaths happen in southern Asia and sub-Saharan Africa.

Most adults and children can be treated at home or at a health centre. Bacterial pneumonia is treated with antibiotics, which must be taken for the full course. People who are very unwell may need hospital care with oxygen. Most people feel better within 2 to 4 weeks, but tiredness and cough can take longer to settle. Vaccines, breastfeeding, clean indoor air and not smoking all lower the risk.

Symptoms

• Cough, which may bring up yellow or green phlegm (sputum)
• Shortness of breath or breathing faster than usual
• High temperature (fever)
• Chest pain that gets worse when you breathe in or cough
• Aching body, extreme tiredness and loss of appetite
• Wheezing (a whistling sound when breathing), which is more common when a virus is the cause
• Sudden confusion, especially in older people
• In babies and young children: fast breathing, or the lower chest pulling inwards with each breath (chest indrawing)
• In babies: grunting noises when breathing, being floppy or hard to wake, or not feeding

Causes and risk factors

Causes

• Bacteria, most often Streptococcus pneumoniae (pneumococcus); Haemophilus influenzae type b (Hib) is another important cause in children
• Viruses such as flu (influenza), respiratory syncytial virus (RSV) and the virus that causes COVID-19
• Germs that normally live in the nose and throat moving down into the lungs, or droplets from coughs and sneezes being breathed in
• Fungi, which are rare in healthy people but matter in people with a weak immune system, such as babies with HIV
• Food, drink or vomit going down into the lungs (aspiration pneumonia)

What makes it more likely

• Age under 5 years (the younger the child, the higher the risk) or over 65 years
• Long-term heart, lung or liver disease, or diabetes
• A weak immune system because of illness such as HIV, or medicines that lower the body's defences
• Malnutrition, especially in babies who are not exclusively breastfed
• Smoking, or living with parents who smoke
• Drinking too much alcohol
• Smoke inside the home from cooking or heating with wood, dung or other biomass fuels
• Crowded housing and being around people with chest infections, especially in autumn and winter

Complications

Pneumonia lowers the amount of oxygen reaching the blood, and severe cases can lead to breathing failure that needs oxygen or intensive care. Germs can spread from the lungs into the blood (bacteraemia), which is serious and can be fatal. Pus can sometimes collect in the space around the lung (empyema) or form a pocket inside the lung (lung abscess). Very ill babies may stop feeding, become cold, have fits or lose consciousness. Pneumonia is the leading infectious cause of death in children under 5 worldwide. Even after the infection clears, tiredness can last for weeks, and full recovery may take up to 6 months.

Diagnosis

A doctor diagnoses pneumonia from your symptoms and an examination, including listening to your chest, counting your breathing rate and checking your temperature, pulse and blood pressure. In a child under 5 with a cough or difficult breathing, fast breathing or chest indrawing is enough to diagnose pneumonia. In adults, doctors use a simple score based on age, confusion, breathing rate and blood pressure to judge how severe it is and whether hospital care is needed. If it is unclear whether a chest infection is pneumonia, a quick finger-prick blood test called CRP (C-reactive protein) can help decide whether antibiotics are needed.

In hospital, a chest X-ray is usually done to confirm pneumonia, along with blood tests. For moderate or severe illness, blood and sputum samples, and sometimes a urine test, are sent to the laboratory to find the germ. A test for flu may be done when flu is spreading. Tests are repeated if a person is not improving after 2 to 3 days of treatment.

Treatment

1. See a doctor or health worker, who will check how severe the pneumonia is and decide whether you or your child can be treated at home or need hospital care.
2. Mild bacterial pneumonia is treated with antibiotic tablets or syrup at home. For children, WHO recommends amoxicillin as the first choice. For healthy adults, guideline options include amoxicillin, doxycycline or a macrolide; adults with other long-term illnesses may be given a combination. Your doctor chooses the medicine and decides the dose.
3. Take the full course of antibiotics even when you feel better. Courses usually last at least 5 days, and your doctor will reassess you before stopping. Antibiotics do not work against viruses, so they are not used when a virus alone is the cause.
4. If you test positive for flu, your doctor may also give an antiviral medicine, which works best when started within 2 days of falling ill.
5. Severe pneumonia, or pneumonia in babies, older people and those with heart or lung disease, may need hospital care with antibiotics, oxygen to help breathing, and close monitoring.
6. Contact your doctor if you are not getting better after 2 to 3 days on antibiotics, as you may need more tests or a different medicine.
7. After treatment, recover gradually: fever usually settles within a week, cough and breathlessness ease by about 6 weeks, and most people are back to normal by 3 to 6 months.

Medicines in Pakistan

Medicines a doctor may use, by group. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.

Also used (not yet in our price list): Antiviral medicine for flu, when flu is confirmed, Vancomycin or linezolid in hospital, only when a resistant germ called MRSA is likely, Oxygen therapy in hospital for low oxygen levels, Co-trimoxazole (sulfamethoxazole with trimethoprim) to help prevent pneumonia in babies and children with HIV or exposed to HIV

Self-care and prevention

Self-care

• Rest, and stay at home while you have a high temperature or cannot manage normal activities
• Drink plenty of fluids
• Finish the whole course of antibiotics, even if you feel better
• Use paracetamol for fever or pain; use ibuprofen only if you have been told it is safe for you
• Avoid cough medicines, because coughing helps clear the infection from your chest
• Cover coughs and sneezes, throw tissues away quickly and wash your hands often with soap
• Do not smoke, and keep smoke away from children
• Keep feeding babies and young children, and breastfeed if you can

Prevention

• Keep children's routine vaccines up to date, including pneumococcal, Hib, measles and whooping cough (pertussis) vaccines
• Older adults, pregnant women and people with long-term conditions should ask about pneumococcal, flu, RSV and COVID-19 vaccines
• Breastfeed babies with breast milk only for the first 6 months
• Reduce smoke in the home by using cleaner cooking stoves and good ventilation, and stop smoking
• Wash hands with soap, cover coughs and sneezes, and stay away from others when you are ill
• Keep long-term conditions such as asthma and diabetes well controlled, and avoid heavy drinking

Common questions

Is pneumonia contagious?

The germs that cause pneumonia, such as bacteria and viruses, can spread through droplets from coughs and sneezes. Not everyone who catches these germs gets pneumonia. Covering coughs, washing hands and staying away from others while ill lower the chance of spreading them.

How long does it take to recover from pneumonia?

Most people feel better within 2 to 4 weeks. Fever usually goes within a week of starting antibiotics, but cough can last around 6 weeks and tiredness may continue for up to 3 months. Most people are back to normal by 6 months.

Does pneumonia always need antibiotics?

No. Antibiotics treat pneumonia caused by bacteria, but they do not work against viruses. Because the two can look alike, your doctor decides whether antibiotics are needed. If they are prescribed, take the full course.

How do I know if my child has pneumonia?

Look for cough or difficult breathing with fast breathing, or the lower chest pulling inwards with each breath. Babies may grunt, feed poorly or be floppy. A child who cannot drink, has fits or is very sleepy needs emergency care.

Can vaccines prevent pneumonia?

Yes, vaccines protect against several of the germs that cause it. For children, WHO says vaccines against Hib, pneumococcus, measles and whooping cough are the most effective way to prevent pneumonia. Older adults and people with long-term conditions may also be offered pneumococcal, flu, RSV and COVID-19 vaccines.

Sources

1. WHO. Pneumonia in children (2022).
2. NICE. Pneumonia in adults: diagnosis and management (CG191) (2019).
3. American Family Physician (summary of ATS/IDSA guideline). Community-Acquired Pneumonia: Updated Recommendations from the ATS and IDSA (2020).
4. CDC. Risk Factors for Pneumonia | Pneumonia | CDC (2026).
5. CDC. Pneumonia Prevention and Control | Pneumonia | CDC (2026).
6. NHS. Pneumonia (2026).
7. NHS. Pneumonia - Treatment (2026).
8. Tropical Medicine & International Health (Owais et al., Aga Khan University). Incidence of pneumonia, bacteremia, and invasive pneumococcal disease in Pakistani children (2010).

Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.

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