In order to decide the appropriate treatment of pneumonia patients should be classified according to the risk they present and, depending on the severity of the symptoms, an outpatient treatment is established or the patient is referred for hospital admission. For this reason, it is usually used some scales that evaluate these aspects and that allow physicians to objectively decide the place of treatment according to the probability of complications (Fine Scale and CURB-65 scale):
Patients who do not require hospital admission: Healthy patients with community-acquired pneumonia with no initial severity data, young patients without risk factors, younger than 65 years with no added risk factors. These patients will undergo treatment and outpatient follow-up.
Patients who require admission to a conventional hospitalization unit: over 65 years of age or with associated pathologies or associated risk factors and all those in which the severity of the presentation of the symptomatology or the presence of other complication risk factors, and Exposed in the previous point, make it advisable to enter the hospital.
Patients requiring admission to the Intensive Care Unit: necessary in situations of extreme severity such as severe respiratory failure, unstable patients with impaired vital signs, failure of kidney function, impaired coagulation system, meningitis, or coma.
Antibiotics for the treatment of Pneumonia
The treatment of pneumonia is done with antibiotics. Antibiotics are chemicals produced by bacteria and fungi that have the ability to inhibit the development or destroy other microorganisms.
Treatment will begin empirically, assessing the most common and probably involved germs, the situation or not of severity, and the response to treatments in the community where the affected patient is located. That is, treatment is started even if the germ that has originated pneumonia has not been determined, based on the previously mentioned criteria to establish the most frequent germ and the appropriate treatment to combat it. follow more blog on my post such as benefits of green tee.
Antibiotic therapy should be initiated as early as possible: within four hours after diagnosis, as it has been shown that early treatment reduces mortality, complications and hospital stay. The most commonly used antibiotics for pneumonia are penicillins and beta-lactams (amoxicillin and amoxicillin / clavulanic, both at high doses), quinolones (levofloxacin, moxifloxacin) and macrolides (azithromycin, clarithromycin). The choice of antibiotic treatment will be made according to the Clinical Guidelines on Treatment, the severity of the condition, and the existence or not of concomitant risk factors.
We must also consider the resistance of certain germs in the area where they are treated. For example, pneumococcus in Spain has a considerable resistance to penicillins (around 20%), so this treatment is not recommended, at least as the only antibiotic, unless it is complemented by another from another category.
Initial choice in patients for outpatient treatment of pneumonia will be the oral route (antibiotic taken by mouth). In those patients who have required hospital admission, the initial treatment will be performed parenterally (intravenous), which will be changed orally after achieving clinical stabilization.
- The initial duration of treatment of pneumonia will vary depending on the different pictures.
- Acquired pneumonia in the community that does not require admission: 7-10 days.
- Acquired pneumonia in the community requiring admission: 10-14 days.
Special cases: non-habitual germs (Legionella, Staphylococcus aureus, Pseudomonas) not less than 14 days. Cases of pulmonary cavitation and abscesses: one month or more. In hospital (nosocomial) pneumonia, it will vary depending on the severity and the germ producing.
Other general measures to cure pneumonia other than antibiotic treatment:
- Analgesics and antipyretics.
- Oxygen therapy according to the levels of arterial oxygen that the patient presents.
- Mechanical ventilation may be required in patients with severe pneumonia.