Community-acquired pneumonia: what it is, treatment and how long it takes to recover

NHS inform describes pneumonia as inflammation of the lung tissue, in which the tiny air sacs in the lungs become inflamed and fill with fluid. It can develop suddenly over a day or two or build over several days, and it is more widespread in autumn and winter.

The label "community-acquired" is used by clinicians to separate infections that start in everyday life from those that develop during a hospital stay or on a ventilator. The distinction matters because the likely germs differ, and so do the antibiotics and the guidance doctors follow. NICE publishes a dedicated guideline on pneumonia diagnosis and management, first issued in September 2025, which covers community-acquired pneumonia in adults, children and young people.

Pneumonia is not the same as a cold or a mild chest infection, although the early symptoms can overlap. NHS inform notes that pneumonia can be hard to diagnose because it resembles conditions such as the common cold, bronchitis and asthma.

The NHS says that if pneumonia is caused by bacteria you will usually be given antibiotics, and that you should keep taking them until you have finished the course even if you feel better. Contact your doctor if you feel no better after 2 to 3 days. NICE says that in adults and in children and young people, antibiotic treatment should be stopped after 5 days unless test results suggest a longer course is needed or the person is not yet clinically stable. The specific antibiotic depends on severity, allergies, pregnancy and local resistance patterns, and is chosen by the prescriber.

NICE guideline NG250 lists amoxicillin as the first-line oral antibiotic for low-severity pneumonia in adults, with doxycycline as an alternative for people with a penicillin allergy or when amoxicillin is unsuitable. Both are written as 5-day courses in the guideline. The prescriber still chooses the drug and dose for you.

Supportive care matters. The NHS advises resting, drinking plenty of fluids and taking paracetamol or ibuprofen if you have been told you can, and says not to take cough medicine because coughing helps clear the infection. NHS inform notes that a warm honey and lemon drink may ease cough discomfort, and that not smoking is more important than ever.

In hospital, the NHS says antibiotics and sometimes steroids are given, with oxygen to help breathing. NHS inform adds that antibiotics and fluids may be given through a drip and that, in very serious cases, a ventilator in a high-dependency or intensive care unit may be needed. NICE says a corticosteroid can be considered for adults with high-severity pneumonia in hospital, in addition to antibiotics.

The NHS lists the common symptoms as a cough, shortness of breath, a high temperature, chest pain, an aching body, feeling very tired, loss of appetite and wheezing. Babies may also make grunting noises, and confusion is common in older people, who sometimes have fewer of the classic symptoms.

• A cough that may bring up yellow or green mucus.

• Breathlessness that is worse than usual or comes on with little effort.

• Chest pain that comes and goes or is sharper when you breathe in or cough.

• Fever, sweats or shivering, and a general sense of being unwell.

• New confusion or drowsiness, particularly in older adults.

• In babies, fast or noisy breathing, poor feeding, or floppiness.

According to NHS inform, pneumonia is commonly the result of pneumococcal infection caused by the bacterium Streptococcus pneumoniae. Other bacteria, viruses and, rarely in the UK, fungi can also be responsible. Viruses such as RSV, coronavirus and influenza can cause pneumonia directly, and the NHS says you can sometimes develop it after another infection such as flu, RSV or COVID-19.

Aspiration pneumonia, which follows food, vomit, water or another substance entering the lungs, is a separate type. NHS inform lists the groups at increased risk as babies and very young children, older people, people who smoke, people with other conditions such as asthma, cystic fibrosis or heart, kidney or liver disease, and people with a weakened immune system.

NHS inform adds that pneumonia is not usually passed from one person to another, so it is safe to be around family members, although people with a weakened immune system should avoid close contact with someone who has it until they begin to recover.

NHS inform says a GP may be able to diagnose pneumonia by asking about your symptoms and listening to your chest. They may check your temperature, breathing rate and breathlessness. Mild pneumonia may be followed by a chest X-ray and blood tests, and a sputum sample is usually not needed unless infections keep recurring or do not respond to treatment.

In primary care, NICE recommends using the CRB65 score to place adults with community-acquired pneumonia into low, moderate or high severity. The score gives a point for each of confusion, a fast breathing rate (30 breaths a minute or more), low blood pressure and age 65 or over. NICE says the score should be interpreted alongside other factors such as other illnesses or pregnancy, and used to guide shared decisions about where someone is treated.

For those who reach hospital, NICE says systems should allow diagnosis, including a chest X-ray, within 4 hours of arrival, and describes further tests for moderate or high severity disease, such as blood cultures and urine antigen tests, depending on the clinical picture. NHS inform adds that under-65s diagnosed with pneumonia should be offered an HIV test, because pneumonia occurs more often in people living with HIV.

The NHS says most people get better in 2 to 4 weeks, and NHS inform says full recovery can take up to 3 months. Asthma + Lung UK says it can take 6 months or more for some people to recover fully. NICE sets out what most adults can expect after treatment starts, shown in the table below, and says the rate of improvement varies with how severe the pneumonia was.

NICE says a routine follow-up chest X-ray is not recommended after discharge, but should be considered at 6 weeks for people with risk factors for lung cancer or other lung disease, such as smoking or being over 50, or with persisting or worsening symptoms or unexplained weight loss. NHS inform likewise says follow-up tests may be arranged if symptoms have not improved, have returned, or you smoke or are over 50. Some people are advised to have a flu or pneumococcal vaccination after recovery.

Call 999 or go to A&E if you are struggling to breathe, choking or gasping and unable to speak, have pale, blue or blotchy skin, lips or tongue, are coughing up blood, or suddenly feel confused. The same applies if you cannot wake a baby or they feel floppy. NHS inform also lists severe central chest pain, pain spreading to the arms, back, neck or jaw, and unusual drowsiness as reasons to phone 999. Do not drive yourself.

Ask for an urgent GP appointment or contact NHS 111 if you have a cough with yellow or green mucus, chest pain on breathing or coughing, or breathlessness. NHS inform adds being unable to keep fluids down, passing less urine than usual, palpitations and a very high or low temperature to the reasons for contacting your GP practice urgently.

The NHS describes four vaccines that protect against infections that can lead to pneumonia: the pneumococcal vaccine for babies, adults over 65 and people at higher risk, the flu vaccine for eligible groups, the RSV vaccine for certain older adults and in pregnancy from 28 weeks, and a seasonal COVID-19 vaccine for people at increased risk. Eligibility changes over time, so your GP surgery or pharmacy can confirm what you can have.

Stopping smoking reduces risk, as does good hand hygiene and covering coughs and sneezes. People with long-term lung conditions such as asthma or COPD are more likely to become seriously ill with pneumonia, according to Asthma + Lung UK, so keeping vaccinations and regular reviews up to date is especially worthwhile for them.

Most pneumonia is assessed by a GP, an urgent treatment centre or NHS 111 and treated in the community, and hospital admission is arranged through A&E or a same-day emergency care unit when a person is very unwell. The NHS covers the antibiotics, oxygen and monitoring involved.

A private chest physician or hospital is more often used afterwards than during the acute illness: for example to look into repeated chest infections, to follow up an abnormal X-ray, or to assess breathlessness that lingers. A private route can offer quicker appointments and imaging, but it does not change how an acute pneumonia is treated, and anyone who is seriously unwell should use emergency services in the usual way.