How is pneumonia diagnosed and treated?

A doctor can often diagnose pneumonia based on the symptoms and by checking your chest. But you may need to have a chest X-ray to confirm that you have it.

Sometimes it can be hard to tell if you have pneumonia or another chest infection. If it’s not clear, your GP may do a blood test or take a phlegm sample to help decide if you need antibiotics.

If you also have COVID-19 symptoms, for example if you’ve lost your sense of smell, your doctor will get you to do a COVID test. This will help find out whether the pneumonia is caused by bacteria or by coronavirus.

Pneumonia can be serious so it’s important to get treatment quickly. The main treatment for bacterial pneumonia is antibiotics. You should also rest and drink plenty of water.

If you’re diagnosed with bacterial pneumonia, your doctor should give you antibiotics to take within four hours.

If you have been diagnosed with pneumonia and you have chest pain, you can take painkillers such as paracetamol or ibuprofen. Some people should not take ibuprofen – check the NHS guidance. Check with your GP if you’re unsure.

Mild bacterial pneumonia

If you have mild bacterial pneumonia, you may be able to manage it at home with treatment from your GP. Your GP will prescribe antibiotics. You will most likely be given an antibiotic called amoxicillin, which is a type of penicillin. If you’re allergic to penicillin, you will be given a different type of antibiotic.

If you do not start to feel better after three days, tell your GP – you may need to try a different type of antibiotic.

More severe bacterial pneumonia

Some people are too ill to be treated at home and need to go to hospital.

If you’re too ill to drink and take tablets, you can have fluids and antibiotics through a drip in your arm. You’ll also be given oxygen if you need it, and the hospital staff can regularly check your temperature and breathing.

Viral pneumonia and COVID-19 pneumonia

Most viral pneumonia goes away by itself. You should rest and drink a lot of water, and you can take painkillers if you are in pain. In some cases, your doctor will prescribe antiviral medicine.

If the pneumonia is very bad you may have to be admitted to hospital and given oxygen to help you breathe.

Coronavirus can cause severe pneumonia, especially for people who already have a lung condition. If you have severe COVID-19 pneumonia you may have to be admitted to hospital and given oxygen. You may also be given a steroid to reduce inflammation and an antiviral medication.

Aspiration pneumonia

If you have aspiration pneumonia, you will be given antibiotics. if your pneumonia is caused by an object you’ve breathed in, you may have a bronchoscopy to look into your airways and lungs. The object may have to be taken out.

Pneumonia can sometimes cause complications. These include:

• respiratory failure – this is when your lungs cannot get enough oxygen into your blood. It usually means you have to go on a machine to help you breathe. Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure that can occur when the lungs become very inflamed.
• pleurisy – this is when the pleura, the thin linings between your lungs and ribcage, become inflamed, leading to chest pain.
• fluid on the lungs – up to 2 in 5 people in hospital with bacterial pneumonia develop fluid around the lung, called a pleural effusion. In most cases, this will not require extra treatment. In some cases, you may need a sample of the fluid to be taken by having a needle put between your ribs. You’ll be given an injection to make the area numb. If it is infected, you may need to stay on antibiotics for longer. Occasionally, doctors will need to put a tube called a chest drain into the lung to remove fluid. If the pleural fluid builds up and becomes infected, a collection of pus can form, known as empyema. This sometimes needs to be drained. In some cases, surgery is needed to remove some lung tissue to allow the lungs to fill up properly.
• a lung abscess – a rare complication that’s mostly seen in people with a serious pre-existing illness or history of alcohol misuse. An abscess may need treatment with different antibiotics, and it will usually take several months to recover.
• sepsis – a life-threatening reaction to an infection. Sepsis needs treatment in hospital immediately because it can get worse quickly.

Most people recover from pneumonia and return to good health. However, pneumonia can be very serious and some people with severe pneumonia die, despite the best available care. Those who are elderly or have other health problems are most at risk of severe or fatal pneumonia.