Pneumonia treatment depends on what’s causing the infection. Bacterial pneumonia requires antibiotics, viral pneumonia may need antivirals, and fungal pneumonia calls for antifungal medications. Most mild to moderate cases can be treated at home, while severe cases need hospital care. The right approach starts with identifying the type of pneumonia and how sick you are.
How Doctors Decide Where You’re Treated
One of the first things a doctor assesses is whether you can safely recover at home or need to be admitted. Hospitals use a scoring system called CURB-65 that looks at five factors: confusion, rapid breathing (30 or more breaths per minute), low blood pressure, elevated waste products in the blood, and age 65 or older. Each factor adds a point. A score of 0 or 1 means home treatment is usually safe, with a mortality risk around 1.5%. A score of 2 puts you in an intermediate zone where short hospital stays or supervised outpatient care may be warranted, since the 30-day mortality risk jumps to about 9%. A score of 3 or higher signals severe pneumonia that needs inpatient treatment, and scores of 4 or 5 may require intensive care.
Your oxygen levels also matter. In the hospital, doctors aim to keep blood oxygen saturation between 94% and 98% for most patients. If your levels drop below that range, you’ll receive supplemental oxygen through a nasal cannula or face mask. People with chronic lung conditions have a slightly different target of 88% to 92%, because pushing oxygen too high can actually worsen their breathing.
Antibiotics for Bacterial Pneumonia
Bacterial pneumonia is the most common type that needs active treatment. For people without risk factors for drug-resistant bacteria, standard options include amoxicillin combined with clavulanate (a compound that helps the antibiotic work against resistant strains) or certain second-generation antibiotics in the same family. If you do have risk factors for resistant infections, such as recent hospitalization or antibiotic use, your doctor will typically choose a fluoroquinolone instead.
You’ll usually start feeling better within a few days of starting antibiotics, but it’s important to finish the full course even after symptoms improve. Stopping early can allow surviving bacteria to rebound or develop resistance. Most outpatient antibiotic courses run five to seven days, though your doctor may adjust based on how you respond.
Walking Pneumonia Is Treated Differently
Walking pneumonia, most often caused by Mycoplasma pneumoniae, doesn’t respond to standard penicillin-type antibiotics at all. That’s because this bacterium lacks a cell wall, which is the exact structure those drugs target. Instead, the CDC recommends macrolide antibiotics as the first choice, with tetracyclines and fluoroquinolones as alternatives. Walking pneumonia tends to be milder, but it can drag on for weeks without proper treatment.
Treating Viral Pneumonia
Antibiotics do nothing for viral pneumonia. When influenza is the cause, antiviral medications work best if started within 48 hours of symptom onset. These drugs shorten the illness and reduce the risk of complications, but their window of effectiveness is narrow.
For COVID-19 pneumonia, two antiviral treatments have full FDA approval. One is a pill combination (nirmatrelvir/ritonavir, sold as Paxlovid) for people with mild to moderate illness who are at high risk of getting sicker. The other is an intravenous drug (remdesivir) that blocks the virus from replicating. Both work best when started within the first few days of symptoms, before the infection has a chance to cause widespread lung damage. For many mild viral pneumonias caused by other viruses, treatment is purely supportive: rest, fluids, and managing symptoms while your immune system does the heavy lifting.
Fungal Pneumonia Requires Longer Treatment
Fungal pneumonia is less common but requires a very different approach and considerably more patience. Two of the most frequent culprits in the United States are histoplasmosis and coccidioidomycosis (valley fever), both caused by inhaling fungal spores from contaminated soil.
Mild to moderate fungal lung infections are typically treated with an oral antifungal for at least 12 weeks. Severe cases start with a powerful intravenous antifungal until the patient stabilizes, then switch to oral medication. The total treatment timeline can stretch much longer than bacterial pneumonia. Chronic pulmonary histoplasmosis, for example, requires 12 to 24 months of antifungal therapy. Valley fever follows a similar pattern: moderate cases need at least 3 to 6 months of treatment, while chronic infections require a minimum of 12 to 18 months. If the fungus spreads to the brain, antifungal therapy becomes lifelong.
What You Can Do at Home
Regardless of the type, supportive care at home makes a real difference in how quickly you recover. Stay well hydrated. Water, broth, and warm liquids help loosen mucus in your lungs and keep you from getting dehydrated, especially if you’ve had a fever. Rest is not optional. Your body is fighting a serious infection, and pushing yourself back to normal activity too soon can set you back.
Over-the-counter fever reducers and pain relievers can help you feel more comfortable. Coughing, while miserable, actually serves a purpose by clearing infected mucus from your airways, so suppressing it completely isn’t always ideal. If coughing is keeping you from sleeping, a mild cough suppressant at night is reasonable, but talk to your pharmacist or doctor about the right choice for your situation. A cool-mist humidifier or a steamy shower can also ease breathing when congestion is heavy.
What Recovery Actually Looks Like
Pneumonia recovery is slower than most people expect. Some people bounce back and return to normal routines within one to two weeks, but for many, it takes a month or longer. Fatigue is the symptom that lingers most stubbornly. Most people still feel tired about a month after their infection, even after the cough and shortness of breath have eased. The timeline depends on the severity of your infection, your age, and your overall health going in.
Lingering cough, mild breathlessness during exertion, and low energy are all normal parts of healing. These symptoms gradually fade, but they can be frustrating if you’re expecting a quick turnaround. Older adults and people with chronic health conditions tend to have the longest recovery curves. If your symptoms are getting worse instead of better after starting treatment, or if you develop new symptoms like high fever or worsening shortness of breath, that’s a sign your treatment plan may need to change.
Preventing Pneumonia in the First Place
Vaccination is the most effective way to prevent the most dangerous forms of bacterial pneumonia. The CDC recommends pneumococcal vaccination for all adults 50 and older who have never received a pneumococcal conjugate vaccine or whose vaccination history is unknown. You have options: PCV20 or the newer PCV21 each require just a single dose, and no follow-up shot is needed. PCV15 is also available, but it requires a second vaccine (PPSV23) about a year later to complete the series. For people with weakened immune systems, cochlear implants, or cerebrospinal fluid leaks, that gap between doses can be shortened to as little as eight weeks.
Annual flu shots reduce your risk of influenza pneumonia, and staying current on COVID-19 vaccines lowers your chance of severe viral pneumonia from SARS-CoV-2. Beyond vaccines, basic habits matter: regular handwashing, not smoking (which damages the lung’s natural defenses), and managing chronic conditions like diabetes or heart disease that make you more vulnerable to infection.