When Antibiotics Make Pneumonia Worse

October 17, 2006
Volume 03    |   Issue 44

Pneumonia is one of the leading causes of death in people over 50 during the winter months. It typically strikes when you have either bronchitis or the flu. Relapses are common, and can lead to prolonged illness or death. That's why doctors usually treat pneumonia with a full 7-10 day course of antibiotics. But now there's evidence that this treatment can increase your risk of relapse and antibiotic resistance.

The proof comes from a study conducted in the Netherlands. The researchers followed 119 patients who had community-acquired pneumonia, or CAP. This is any pneumonia developed outside of a hospital or nursing home. They found that the 7-10 day course of antibiotics isn't the most effective or the safest treatment.

In this study, the researchers gave all the patients amoxicillin intravenously for three days. Then they separated those who improved substantially from the rest of the group and divided them into two groups. One group received oral amoxicillin for five more days. The other group received a placebo.

The success rate for each group of patients was similar. Three days of antibiotics worked as well as 7-10. But the shorter course had a huge advantage:  It lowered the risk for antibiotic resistance. And it also reduced the risk of relapse.

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Does this mean you should never use the full course of antibiotics? No, it doesn't. Sometimes you have to take the full course.  Fortunately, there's an easy way to tell:

If you get pneumonia, take a three-day course of intravenous antibiotics.  Then, ask your doctor to check your procalcitonin levels.  (Procalcitonin is a substance produced in the thyroid that is elevated in bacterial infections.)  If your levels are still high after 3 days, you may need to take the full course.  But if your levels are low, then don't take any more treatment. Too many antibiotics create more health problems, not less.

Your voice of reason in Women's Health,


Prins, J.M. "Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomized double blind study," BMJ, vol 332, 2006.

Muller, B., MD. "Biomarker reduces length of antibiotic treatment," Amer Journ Respiratory and Crit Care Medicine, July 2006.

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