Can You Recover From Pneumonia Without Antibiotics?

When we get sick, often the first thing we think that we need is antibiotics. Especially with respiratory infections, such as acute bronchitis or pneumonia, we want to take medication to make us feel better. But there may be other ways to treat chest infections? Below we discuss pneumonia and how to manage it with other treatment options. 

About pneumonia 

What is pneumonia

The World Health Organisation (WHO) defines pneumonia as inflammation affecting the tissues of your lungs. Often, it is a respiratory infection caused by bacteria, viruses, or fungi. The lungs consist of tiny sacs of air known as alveoli. In pneumonia, the alveoli become filled with substances, like fluid and pus. This means there is less oxygen available to the lungs and breathing becomes difficult and painful. 

Types 

Pneumonia can be classified based on how it was acquired, how it was caused, or how severe the symptoms are. If developed during at least 48 hours of a hospital stay, it is considered hospital-acquired pneumonia, or nosocomial. Anything outside of a hospital environment is community-acquired pneumonia.¹

Causative agents of pneumonia can either be from an infection or by ingestion of a foreign substance. Aspiration pneumonia occurs when something other than air enters your lungs such as saliva, vomit, or food.

The severity of pneumonia symptoms can be mild to moderate to severe. Mild pneumonia, informally named ‘walking pneumonia’, refers to pneumonia with symptoms that do not lead to bed rest or a hospital visit. Severe pneumonia is when other organs besides the lungs are affected, or when there is not enough oxygen available for the body to use resulting in more serious complications. 

Causes 

Bacteria, viruses, and fungi can cause pneumonia. Pneumococcal pneumonia is the most prevalent community-acquired form of the disease, caused by the bacteria Streptococcus pneumoniae.² 

Other bacteria that can commonly cause the disease are: 

• Haemophilus Influenzae  
• Staphylococcus aureus 
• Group A Streptococci³

If acquired in the hospital, the cause of pneumonia could be MRSA or Pseudomonas aeruginosa pathogens. Less frequent pathogens, such as Legionella, Mycoplasma Pneumoniae, and Chlamydia Pneumoniae cause atypical pneumoniawhich often cause milder pneumonia symptoms.³ 

Besides bacteria, viruses may also pose a risk of developing into pneumonia and other chest infections. These include:

• Respiratory syncytial virus (RSV)- Most common in small children 
• Influenza virus 
• COVID-19⁴

Fungal pneumonia is less common than its counterparts, mainly affecting those already immunocompromised. Fungi exist in the environment in soil and animal excretion.⁵

Risk factors

The NHS cites the following groups as those who are most at risk of pneumonia:

• The very young and the very old 
• Smokers 
• People with pre-existing medical conditions- cystic fibrosis, lung disease 
• People with weakened immune systems- from HIV/AIDS, chemotherapy, or flu 

Aspiration pneumonia risk factors also include:

• Drug use 
• Alcohol use
• Having swallowing difficulties (found in Parkinson’s disease, multiple sclerosis, or those with a brain injury) 

Symptoms 

The NHS lists a number of common signs and symptoms depending on the presentation of pneumonia and severity of the infection including: 

• Cough
• Fever and chills
• weating
• Feeling short of breath
• Chest pain worse on breathing or coughing 
• Feeling tired 
• Feeling unwell
• Rapid heartbeat 

Less common symptoms recognised by the NHS are:

• Pain in your bones and muscles 
• Nausea or vomiting 
• Headaches 
• Coughing up blood (hemoptysis) 
• Confusion, drowsiness

The cough produced by pneumonia may be dry, or you may contain mucus or sputum. Its colour may indicate the underlying bacteria:

• Rust coloured- Strep.pneumoniae
• Green- Pseudomonas
• Red currant jelly-Klebsiella³

Mayo Clinic recommends visiting a doctor if you are experiencing chest pain, a high fever (39°C), a persistent cough or difficulty breathing.

Treatment

Hospital treatment

Pneumonia treatment may require a hospital stay for those who are more vulnerable or have severe pneumonia symptoms. These include:

• People over 65 years old 
• Confusion, disorientation 
• Low blood pressure (below 90/60 mm Hg) 
• Rapid, shallow breathing (more than 30 breaths per minute) 
• A heart rate that is either too fast or too slow 
• Decreased kidney function 
• Low temperature 
• Breathing assistance is needed 

Once admitted, severe cases may need treatment in an intensive care unit to receive breathing support via a ventilator. Bacterial pneumonia is treated with antibiotics and certain antibiotics, or a combination of drugs, work against different types of bacterial pneumonia. Additional tests may be needed to identify the cause of the lung infection to help target therapy accordingly. Alongside antibiotics, supportive therapy with IV fluids and painkillers to help with the chest pain may be given. 

At home treatment 

Mild pneumonia does not require treatment in the hospital. Instead, healthcare providers can prescribe the same antibiotics they would give in the hospital to be taken at home. Fever can be controlled by over-the-counter medications such as paracetamol, Ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs) that will also help relieve chest pain. You should always take care to read the health and age-dependent dosage instructions on over-the-counter pain relief medications and you should never give Aspirin to children.⁶

Outlook

Can you recover without antibiotics?

Depending on the type of pneumonia, antibiotics are not always needed. Viruses and fungi do not respond to medications targeted towards bacteria as they are different organisms. In viral pneumonia, supportive care is the first treatment option. Supplementary oxygen, fluid replacement, and symptomatic treatment are used. 

In severe cases, antiviral medication may be prescribed to reduce the severity of symptoms and reduce the course of the illness. Fungal pneumonia also has its own specific therapy: Antifungal medication.   

For mild pneumonia, the symptoms of the disease are not enough to warrant hospital admission or treatment. Instead, home remedies used for chest infections and other minor respiratory illnesses are recommended. If symptoms worsen or do not disappear over time, then contact a healthcare provider. 

Is pneumonia serious?

Mild pneumonia rarely causes serious health effects but you should consult your doctor nevertheless. More serious cases of a pneumonia infection can lead to more critical problems due to a weakened immune system. This is more often the case in bacterial pneumonia rather than viral. 

Serious complications of pneumonia include: 

• Sepsis 
• Pleural effusion 
• Lung abscess 
• Respiratory failure⁷

Sepsis, previously referred to as blood poisoning, is a life-threatening complication of bacterial pneumonia. It results from an infection that overwhelms the body’s immune system and can cause damage to the organs, cause a change in mental capacity, and in severe cases, cause a rapid drop in blood pressure, known as septic shock.⁸ 

Pleural effusion is the accumulation of fluid between the membrane layers that line the lungs: the pleura. This condition can sometimes be referred to as ‘water on the lungs’. It worsens the symptoms of chest pain, shortness of breath, and cough. If too much fluid has built up in this space or becomes infected, then it may require draining.⁹ 

A lung abscess is a localised collection of pus. This has the potential to cavitate and form a communication with other parts of the pulmonary tree, known as a bronchopulmonary fistula.¹⁰  

In severe cases, when the lung can’t get enough oxygen from the air to the blood, respiratory failure can occur. Build up of carbon dioxide causes damage to the organs and poses a threat to mortality. Fortunately, respiratory failure is a rare complication of pneumonia and is only more likely in those with pre-existing medical conditions.¹¹ 

Lifestyle changes to improve recovery 

Besides medication, there are several things you can do at home to help recover from pneumonia:

• Stay hydrated - Drinking plenty of fluids helps loosen the mucus in your airways and will make breathing easier 
• Eat well - A good, well-balanced diet will help strengthen your immune system 
• No smoking - Avoid smoke until the chest infection has cleared and ideally, quit smoking altogether to improve your overall health and prevent many other illnesses, infections, and chronic diseases (if you have trouble quitting, consult your doctor for the best advice)  
• Get plenty of rest - Take it easy for as long as you need and don’t overwork youself with physical activity until you feel better 
• Use steam and humidity - steam helps open up your airways so you can do things such as taking hot baths or showers, drink warm beverages, or use a humidifier to help your breathing 

Summary

Bacterial pneumonia is best treated with antibiotics, however, not all pneumonia infections require this medical intervention. There are plenty of ways to help yourself overcome your pneumonia symptoms - looking after your general health at home and listening to your body will help you recover faster from infection. If you’re concerned about your symptoms or health, you should always consult a medical professional. Ultimately, your doctor will be able to best assess your particular case and help you decide the best course of action to treat your symptoms.