Treatment of pneumonia in an adult
Diseases of the respiratory system have a high risk for humans. One such common pathology is pneumonia, which causes inflammation of the lung tissue and irreversible changes in it. To avoid oxygen starvation of tissues, the disease must necessarily start on time to treat.
How to treat pneumonia at home in adults
Pneumonia often has a viral nature, but even in other cases, it is joined by bacterial infection, so adults are required to perform antibiotic therapy, appointing 1-2 drugs Simultaneously. The treatment standards take into account several factors:
- type of pneumonia;
- volume of damage to lung tissue;
- state of health and age of the patient;
- concomitant diseases of the heart, kidneys or lungs.
Adults prescribe antibiotics for pneumonia, taking into account their age, and even with negligible the effectiveness of a single drug does not change it within 3 days or until a sputum test is decoded patient. For the treatment of pneumonia use modern popular drugs under the names:
- Ceftriaxone. As a form of release, white powders are used for the preparation of injections. The course of treatment of pneumonia is determined by the doctor depending on the degree of severity. For an adult, the dose is 1-2 g daily. A solution for injections is prepared from 500 mg of the drug and 2 ml of a 1% solution of lidocaine, and for the droppers 5 ml of sterile water are used. The price is from 25 rubles, it is sold by prescription.
- Sephpotek. Antibiotic, also allowed a child with 12 years. Effective in the treatment of pneumonia and other respiratory tract infections. Adults need to take 200 mg - 1 tablet, with an interval of 12 hours. End the course of treatment is necessary in 2 weeks. Price from 120 rub.
- Sumamed. In addition to tablets, it is available as a powder or lyophilizate. It is indicated for infectious and inflammatory diseases, including respiratory tract. From pneumonia, you need to take 500 mg of the drug per day treatment course, equal to 3 days. The price from 520 r.
Folk treatment of pneumonia in adults is effective in combination with taking medications if therapy is done at home. To do this, you can use the following recipes:
- Decoction of raisins. Rinse, art. Dark raisins, pass it through the meat grinder. Gulf a glass of boiling water, soak under the lid for about 10 minutes. To treat inflammation of the lungs with such a decoction it is necessary, drinking on, art. daily.
- "Milk" milk. Prepare 3 dried white figs. Heat the milk, pour the fruit, cook over a small fire for about half an hour. To treat pneumonia, drink 2 glasses a day until symptoms improve.
- Nastoy on the nuts. Take 500 ml of dry red wine. Fill them with 50 g of peeled nuts. Strew the remedy on a low heat for about a quarter of an hour. Eat 1 tbsp each. before each meal.
To begin with, it is recommended that you change your position frequently in bed and do not lie on your side, which hurts. After 3-4 days, when the acute period of the disease is already behind, you can begin respiratory gymnastics, for which you lie on your back and put your hands on your stomach. You need to exhale after a deep breath, but do it slowly, straining your abdominal muscles. Approaches should be at least 5 per day, each of which includes 15 reps. It is recommended to use LFK and for the prevention of pneumonia.
Features of treatment of pneumonia
Treatment of pneumonia in an adult depends on many factors, the first of which is the type of this disease. Therapy for the elderly is mandatory in the hospital, otherwise the decision is made by the doctor. The algorithm of treatment consists of several stages. First pneumonia is diagnosed, then the focus of inflammation is eliminated with antibiotics. Next, additional medications are prescribed for the remaining signs of the disease.
In adults this form arises more often than others and is divided into right-sided and left-sided. A particular species is bilateral, when lesions are present in both lungs. Treatment of pneumonia in an adult is carried out permanently with the use of antibiotics, physiotherapy, inhalations and elimination of allergic reactions. With a one-sided or bilateral form, you need to ensure the correct position of the patient - semi-sitting to improve the performance of the lungs.
Viruses, bacteria or fungi and parasites lead to the viral form. The first two days for the treatment of pneumonia for an adult are prescribed to take antiviral drugs, such as Tamiflu or Ingavirin in the influenza nature and Acyclovir in the causative agent causing varicella. In addition to these medicines, the patient is prescribed antipyretic, analgesic and cough suppressants that help to sputum. Antibiotics are prescribed only with the addition of bacterial infection.
This type of pneumonia is also called focal. It develops against the background of bronchitis, therefore it is especially dangerous due to its consequences - pleuropneumonia, abscess and even gangrene, therefore the methods of treatment are chosen only by a doctor. Antibiotics become mandatory in therapy, and they are chosen according to the degree of influence on the intestinal microflora. Ecoantibiotics are often used. In addition, adults are treated with drugs that dilute, excrete phlegm and restore the immune system.
The most serious of all is the atypical form, because it is caused by atypical pathogens and often there is such pneumonia in an adult without temperature. The insidious disease is also due to the fact that it has a latent period when the symptoms are practically absent. Antibiotics are often unable to cope with the manifestations of this type of pneumonia, so an adult is prescribed immunoglobulins and special procedures for sucking out fluid in the lungs. Treatment is complemented by a complex of vitamins and antipyretic.
Another complex form of pneumonia is the radical one. It is difficult to diagnose, because the symptoms are similar to tuberculosis and central lung cancer. Drugs for treatment are prescribed immediately after diagnosis, with several drugs at the same time, that the condition was relieved in 2-3 days and the patient could be prescribed heating and exercise therapy.
Treatment of pneumonia in the hospital
Indications for hospitalization are deterioration of the patient's condition or inability to apply the necessary drugs at home. With timely treatment, relief comes in 2-4 days, but possible complications increase the duration of stay in the hospital to 10 days, and often up to 4 weeks. The patient is given injections or drips with antibiotics, then physiological saline is injected in the same way to detoxify the body. In combination with these drugs, adults are prescribed expectorant and antipyretic agents.
How much is pneumonia treated?
Treatment of community-acquired pneumonia in adults is done at home and takes 7 to 10 days. It adds a period for the restoration of the body, which can take from 1 to several months. The same amount can be used to fight chronic pneumonia. The duration of treatment depends on the timeliness of therapy. In addition, the effectiveness of the selected drugs is also important. Inpatient therapy has an average duration of 9-10 days with severe form. Stagnant pneumonia can be cured in 20-25 days.
Video about respiratory gymnastics with pneumonia
Pneumonia - treatment of folk remedies at home | Folk recipes for the treatment of pneumonia
An acute infectious disease of predominantly bacterial etiology, characterized by focal lung involvement, is called pneumonia. Phytotherapy for this disease can be carried out only with strict adherence to the regime and adequate care for the patient.
Folk recipes for the treatment of pneumonia
After an accurate diagnosis of the doctor, you can try phytotherapy. From coughing, heaviness in the chest, mucus and sputum in the lungs can get rid of folk medicine. Here are the most effective folk remedies.
1. Infusion of herbs
Mix the root and leaves of mother-and-stepmother with oregano. Pour boiling water and let stand for about an hour. Take in a strained form half the glass twice a day before eating.
2. Medicinal Decoction
In the same doses take the roots of the althea, sage leaves and licorice, pine buds, fruits of anise. Pour hot with boiled water. Drink a week for one-quarter cup every three hours.
After folk treatment, you will necessarily feel lightness in the lungs, get rid of pain in the chest and cough, as herbal infusions clean the respiratory tract.
3. Honey infusion
Bring to a boiling state a mixture of a teaspoon of honey, a tablespoon of anise seeds and salt. Drink folk remedies every 2 hours.
4. Balm from the century
A few leaves of aloe pour Cahors with liquid honey, insist for 14 days. To eat before eating food three times.
5. Plantain Compress
Ask someone from the relatives before going to bed to put clean leaves of plantain on your back and on your chest. Top with a towel and wrapped in a cellophane bag. Wear a woolen sweater or take cover with a warm blanket. The next morning all the unpleasant symptoms of pneumonia will disappear.
6. Excellent help herbal teas. These are linden, sage, elecampane, raspberry, oregano, willow, turn, elder and many others. They are taken in hot form, you can add honey.
7. You can take propolis, which serves as an excellent way against infectious diseases. Honey water also eliminates the symptoms of the disease and greatly facilitates breathing.
8. Home remedy, which very well restores the lungs, is prepared on the basis of one tablespoon of St. John's wort and three tablespoons of elecampane, this collection should be poured, a lira of boiling water. All this is left for 30 minutes, then cool the broth, drain. In the already cooled broth add two glasses of liquid honey and two hundred milliliters of olive oil. Mix thoroughly until a homogeneous mass is obtained and leave to infuse in the refrigerator for two weeks, after which the pneumonia remedy is ready for use. To treat pneumonia, you need to use one teaspoon for thirty minutes before eating five times a day.
9. Actual and most important is the treatment with balsam. It is prepared on the basis of 250 grams of aloe, half a liter of Cahors, 350 grams of liquid honey. Leaves scarlet need to be thoroughly wiped, in no case wash. After that, they need to be crushed and put in a jar, pour honey mixed with Cahors. The resulting mixture is insisted in a dark cool place for two weeks. Then the filtered mass must be squeezed. Taking this balm three times a day for one tablespoon will relieve all kinds of lung diseases, and will act as a general restorative.
10. Elder - also an effective remedy for pneumonia, we take four preferably big umbrella of elderberry fill, we insist on liters of vodka for fourteen days and everything is ready. You should take one hour before eating one tablespoon.
11. It is very important to do inhalation. A bandage rubbed with onions should be placed in a mug and try to breathe over it for ten minutes at least seven times a day. This type of inhalation is very effective in the treatment of any even the most advanced stage of the disease, as well as bronchitis and angina.
Effective ways to treat pneumonia with charges
1. Grass of a lungwort, a plantain of a large, sage medicinal, an auricle of an umbelliferous, a wormwood for the treatment of pneumonia is equally divided.
2. Grass grass, anise fruits, dill fruits, pine buds, herb thyme, licorice root (crushed) - equally.
3. Althaea root, birch leaves or buds, elecampane root, St. John's wort, grass of the moth, grass of the turn, leaves eucalyptus, angelica root, motherwort grass, sweet clover grass, mullein flowers, cyanosis grass, dill fruits - equally.
4. Grassy grass, clover flowers, raspberry leaves, coltsfoot leaves, chamomile flowers, yarrow herb, thyme herb, herb clearweed, Ledum sprouts, three-color violet grass - equally.
5. Grass of oregano, bilberry bilberry, leaves of spray, leaves of coltsfoot, mint leaves, dandelion root, leaves plantain, licorice root, rose hips, herbage grass, root of the primrose, leaves cuffs - equally.
6. Calendula flowers, clover flowers, plantain leaves, pine buds, sage leaves, rose hips, gravel root, grass motherwort, veronica grass, cyanosis grass, dill fruits, hawthorn fruit - equally for the treatment of pneumonia with folk remedies .
7. Birch buds, elecampane root, bark or berries of viburnum, raspberry leaves, sage leaves, lilac flowers, root of althea, grass of wormwood, herbage of motherwort, shoots of ledum, mullein flowers, fruits of coriander - equally.
8. Fruits of dill, herb of oregano, nettle grass, leaves of coltsfoot, pine buds, eucalyptus leaves, yarrow, gravel root, violet grass, cuff leaves - equally.
9. Leaves or buds of birch, kalina bark, grass of the moth, mint grass, clearing grass, St. John's wort, calendula flowers, herb thyme, angelica root, cyanosis grass - equally.
10. Herb of oregano, chamomile flowers, rose hips, psyllium leaves, licorice root, herbage, herbs of thermopsis - equally.
Treatment of pediatric pneumonia with folk remedies
For children, it is recommended to prepare infusions and decoctions in the following daily dose of dry medicinal collection: up to 1 year - 1 / 2-1 hour. l., 1 to 3 years - 1 hour. l., from 3 to 6 years - 1 dess. l., from 6 to 10 years - 1 tbsp. l., older than 10 years - 2 tbsp. l.
Plants, previously shredded (in a coffee grinder or meat grinder), mix, 2 tbsp. l. collecting pour 1 liter of boiling water, bring to a boil, boil over low heat for 10 minutes in a sealed container, poured along with the grass in a thermos, insist the night.
Take during the day for 100-150 ml 30 minutes before eating. To improve the taste, you can add honey, sugar, jam. The course of treatment of pneumonia is 3-4 months.
The collection of herbs can be used in combination with other medicines. Before taking this or that collection, it is advisable to familiarize yourself with the contraindications to the herbs included in this collection.
We must not forget that if pneumonia with complications, then the phytotherapy can only serve as an addition to the basic forms of treatment and to the course of taking antibiotics. Categorically it is not recommended to engage in self-medication, this will only complicate the state of your health. With a sudden rise in body temperature, fainting and shortness of breath, immediately call for an ambulance. An accurate and correct diagnosis can be made only by an experienced doctor with the appointment of laboratory tests and X-rays.
After full recovery is recommended to rest in a sanatorium or dispensary, where there is adequate nutrition, inhalation, acupuncture, gymnastics, physical exercises and professional massage.
Rules of care for pneumonia in the home
A variety of measures can be taken for treatment:
1. Pleuric pain in the chest with pneumonia in adults can sometimes be weakened by applying an electric heating pad to it, wrapped in a pillow case from the pillow and superimposed over the underwear of the patient. Thus it is necessary to be cautious, if the patient is restless, immovable or his consciousness has become confused.
2. If the patient has a high temperature, then to maintain the hygiene of the body, bed linen and underwear made of cotton, as well as washing the patient and applying talcum if necessary.
3. Relief of the patient's condition is promoted by regular brushing of teeth, mouth rinsing, flushing of dentures (who they have), and sucking ice cubes.
4. It is very important in the treatment of pneumonia in the home to regularly give the patient to drink, because the high temperature is associated with dehydration of the body. (compotes from dried fruits, juices, fruit drinks, teas and decoctions of herbs, milk with honey, mineral water). At a fever to accept not less, than 3 liters of water. It's okay if the patient loses appetite during an acute attack of the disease - as soon as he gets better, the appetite will return.
5. During the period of pneumonia, bed rest should be strictly observed. Sometimes sit down for a cough of phlegm.
6. The room where the patient is to be kept must be kept in a constant clean, often ventilated. The air must be moist and clean. The room should be cool.
7. The food of the patient should be high-calorie, vitamin and containing trace elements. It's all kinds of vegetables, fruits. When the organism is intoxicated, it is recommended that the food be ground with a blender.
8. It is necessary to follow the intestines, not to allow constipation and the development of flatulence.
9. For a better separation of phlegm, mucus from the lungs make a special massage. With the help of relatives or a massage therapist massages the area of the chest and back, hands and feet with circular motions. There is a point (light stroking touch, pressing the sore point with your finger for ten minutes) and classic segmental massage. Also effective in the treatment of breathing exercises, which helps to eliminate respiratory failure. Physical exercises that facilitate breathing and the withdrawal of phlegm, activate blood circulation.
10. For ease of breathing, pneumonia in an adult is helped by saline and alkaline inhalations.
11. You can treat pneumonia at home, using cans, mustard plasters, make warming compresses, wraps. This contributes to sputum coughing.
It usually takes several weeks for a full recovery, although this depends on the individual characteristics of the patient. During the recovery period, often there are bouts of depression. All the above measures for caring for the patient can be applied in case of bronchitis.
Prevention of pneumonia with folk methods
Many doctors recommend for the prevention of pneumonia to strengthen the body and immunity herbal decoctions. Honey - a universal remedy for the prevention of disease 1-2 tablespoons with hot drink, the same norm with raspberry jam. Increase the consumption of onions and garlic. Recommended herbs: raspberry leaves, elderberry, mother-and-stepmother and other anti-inflammatory herbs.
But any disease can be prevented if you engage in your body and strengthen your immune system. First of all, this is hardening for the prevention of pneumonia. For young children, this process should become the norm. Patterned back and chest massage for improved circulation of blood and air. The preventive course of the vitamin complex for the prevention of pneumonia has not harmed anyone. And remember, warned - armed, and therefore ready! Your health and the health of your loved ones are in your hands!
Pneumonia in adults
Pneumonia is an acute inflammation of the lungs caused by infection. The initial diagnosis is usually based on the chest x-ray.
Causes, symptoms, treatment, prevention and prognosis depend on whether the infection is bacterial, viral, fungal or parasitic; hospital, or hospitalized in a nursing home; develops in an immunocompetent patient or against a background weakened immunity.Code for the ICD-10 J18 Pneumonia without specifying the pathogen
Pneumonia is one of the most common infectious diseases. In Europe, the annual number of patients with this diagnosis is between 2 and 15 per 1000 population. In Russia, the incidence of community-acquired pneumonia reaches 10-15 per 1000 population, and in older age groups (over 60 years) - 25-44 cases per 1000 people per year. Approximately 2-3 million people in the US are ill with pneumonia every year, about 4, 00 of them die. This is the most common hospital-acquired infection that has a lethal outcome, and is the most common of the common causes of death in developing countries.
Despite significant progress in diagnosis and treatment, mortality in this disease is increasing. Community-acquired pneumonia is the most common cause of death among all infectious diseases. In the general structure of causes of death, this disease ranks fifth after cardiovascular, oncological, cerebrovascular diseases and COPD, and in the older age group, lethality reaches 10-33%, and among children under 5 years - 25%. Even more high mortality (up to 50%) is characterized by the so-called hospital (hospital or nosocomial) and some "atypical" and aspiration pneumonia, which is due to the highly virulent flora that causes the listed forms of the disease, as well as the rapidly developing resistance to traditional antibacterial medicinal drugs.
The presence of a large number of patients with severe concomitant diseases and certain risk factors, including number of primary and secondary immunodeficiency, has a significant effect on the course and prognosis pneumonia.
Causes of pneumonia
In adults over 30 years, the most frequent pathogens of pneumonia are bacteria, and in all age groups, under all socio-economic conditions and in all geographic areas, Streptococcus pneumoniae. However, pneumonia can cause any pathogens, from viruses to parasites.
The respiratory tract and lungs are constantly exposed to the pathogenic organisms of the environment; upper respiratory tract and the oropharynx are especially colonized by the so-called normal flora, which is safe due to immune defense organism. If pathogens overcome numerous protective barriers, an infection develops.
See also: Inflammation of the lungs
The protective factors of the upper respiratory tract include IgA saliva, proteolytic enzymes and lysozyme, and growth inhibitors produced by normal flora and fibronectin that covers the mucosa and inhibits adhesion. Nonspecific protection of the lower respiratory tract includes cough, clearance of the ciliated epithelium and angular structure of the respiratory tract, which prevents infection of air spaces. Specific protection of the lower respiratory tract is provided by pathogen-specific immune mechanisms, including opsonization of IgA and IgG, anti-inflammatory effects of surfactant, phagocytosis by alveolar macrophages and T-cell immune reactions. These mechanisms protect most people from infection. But in many conditions (for example, in systemic diseases, malnutrition, hospitalization or stay in a nursing home, antibiotic therapy), normal flora changes, its virulence increases (for example, when exposed to antibiotics), or protective mechanisms are broken (for example, when smoking cigarettes, nasogastric or endotracheal intubation). Disease-causing organisms, which in these cases reach the alveolar spaces inhalation, due to contact or hematogenous spreading or aspiration, can multiply and cause inflammation of the pulmonary tissue.
Specific pathogens that cause inflammation of the lung tissue are not excreted in more than half the patients, even with a comprehensive diagnostic study. But, since under similar conditions and risk factors there are certain trends in the nature of the pathogen and the outcome of the disease, pneumonia are classified into out-of-hospital (acquired outside the health facility), hospital (including postoperative and associated with artificial ventilation of the lungs), acquired in nursing homes, and in immunocompromised individuals; this allows you to assign empirical treatment.
The term "interstitial pneumonia" refers to a variety of unrelated states with unknown etiology, characterized by inflammation and fibrosis of pulmonary interstitium.
Community-acquired pneumonia develops in people with limited contact or without contact at all with medical institutions. Streptococcus pneumoniae, Haemophilus influenzae and atypical microorganisms are commonly identified (i.e. e. Chlamydia pneumoniae, Mycoplasma pneumoniae Legionella sp). Symptoms - fever, cough, shortness of breath, tachypnea and tachycardia. The diagnosis is based on clinical manifestations and chest X-ray. Treatment is carried out empirically selected antibiotics. The prognosis is favorable for relatively young and / or healthy patients, but many pneumonia, especially those caused by S. pneumoniae and the influenza virus, are fatal in the elderly and weakened patients.
Many microorganisms cause out-of-hospital pneumonia, including bacteria, viruses and fungi. In the etiologic structure different pathogens prevail depending on the patient's age and other factors, but the relative importance of each as a cause of the out-of-hospital inflammation of the lungs is questionable, since most patients do not undergo a complete examination, but even with a survey, specific agents are detected in less than 50% of cases.
S. pneumoniae, H. influenzae, C. pneumoniae and M. pneumoniae - the most frequent bacterial pathogens. Chlamydia and mycoplasma are clinically indistinguishable from other causes. Frequent viral pathogens are the respiratory syncytial virus (RSV), adenovirus, influenza virus, metapneumovirus and parainfluenza virus in children and influenza in the elderly. Bacterial superinfection may make it difficult to differentiate the viral from bacterial infection.
FROM. pneumoniae causes 5-10% of community-acquired pneumonia and is the second most frequent cause of lung infections in healthy people aged 5-35 years. FROM. pneumoniae is usually responsible for outbreaks of respiratory tract infections in families, educational institutions and military training camps. It causes a relatively benign form, rarely requiring hospitalization. Pneumonia caused by Chlamydia psittaci (ornithosis) occurs in patients with birds.
Reproduction of other organisms causes lung infection in immunocompetent patients, although the term community-acquired pneumonia is commonly used for more frequent bacterial and viral etiologies.
Ku fever, tularemia, anthrax and plague are rare bacterial infections in which there may be severe pneumonia; the last three infectious diseases should raise suspicion of bioterrorism.
Adenovirus, Epstein-Barr virus and Coxsackie virus are widespread viruses that rarely cause pneumonia. Chicken pox and gantavirus cause infection of the lung with chickenpox in adults and gantavirus pulmonary syndrome; A new coronavirus causes severe acute respiratory syndrome.
The most frequent fungal pathogens are Histoplasma (histoplasmosis) and Coccidioides immitis (coccidioidomycosis). Less common are Blastomyces dermatitidis (blastomycosis) and Paracoccidioides braziliensis (paracoccidioidomycosis).
Parasites that cause lung damage in patients in developed countries include Plasmodium sp. (malaria) Toxocara canis or catis (migration of larvae to internal organs), Dirofilaria immitis (dirofipyariosis) and Paragonimus westermani (paragonimiasis).
Symptoms of pneumonia
Symptoms of pneumonia include malaise, coughing, shortness of breath, and chest pain.
Cough is usually productive in older children and adults and dry in infants, young children and the elderly. Dyspnoea is usually mild and occurs with physical activity and is rarely present at rest. Pain in the chest is pleural and localized next to the affected area. Inflammation of the lung tissue can be manifested by pain in the upper abdomen, when the infection of the lower lobe irritates the diaphragm. Symptoms vary in extreme age groups; Infection in infants can manifest as vague irritability and restlessness; in the elderly - as a violation of orientation and consciousness.
Manifestations include fever, tachypnea, tachycardia, wheezing, bronchial breathing, euphony and dullness with percussion. Symptoms of pleural effusion may also be present. Inflammation of the nostrils, the use of extra muscles and cyanosis are frequent in infants.
Signs of pneumonia, as previously thought, differ depending on the type of pathogen, but there are a lot of common manifestations. In addition, none of the symptoms or symptoms are sufficiently sensitive or specific to be able to determine the etiology on its basis. Symptoms may even resemble non-infectious lung diseases, such as pulmonary embolism, neoplasms and other inflammatory processes in the lungs.
Where does it hurt?Chest pain Chest pain after pneumonia Chest pain with inspiration Chest pain when coughing
What's bothering you?Shortness of breath Body temperature Chrypses in lungs Cough
Diagnosis of pneumonia
The diagnosis is suspected on the basis of the symptoms of the disease and is confirmed by chest radiography. The most serious condition, mistakenly diagnosed as an inflammation of the pulmonary tissue, is pulmonary embolism, which is more is likely in patients with minimal sputum production, absence of concomitant ARVI or systemic symptoms and risk factors thromboembolism.
When chest radiography is almost always found infiltration of a certain degree of severity; rarely infiltration is absent in the first 24-48 hours of the disease. In general, no definite results of the study distinguish one type of infection from another, although multi-dose infiltrates suggest infection of S. pneumoniae or Legionella pneumophila, and interstitial pneumonia involves viral etiology or mycoplasma.
A generalized blood and electrolyte test, urea and creatinine should be performed by a hospitalized person to determine the degree of hydration and risk. Two blood cultures are done to detect pneumococcal bacteremia and sepsis, as approximately 12% of all patients hospitalized with pneumonia have bacteremia; S. pneumoniae accounts for two thirds of these cases.
Studies are continuing to help determine whether the results of blood cultures are so important for treatment to justify the costs of these analyzes. Pulse oximetry or analysis of arterial blood gases should also be performed.
Usually, there is no evidence to conduct research, including the analysis of sputum, identifying a pathogenic microorganism; exceptions can be made for critically ill patients, suspected drug resistant or unusual microorganism (eg, tuberculosis), and patients whose condition worsens or who do not respond to treatment in for 72 hours. The feasibility of Gram staining and bacteriological examination remains questionable, since samples are often contaminated and their overall diagnostic effectiveness is low. In patients who do not produce sputum, samples can be obtained non-invasively by simple cough or after inhalation of hypertonic saline, or the patient may undergo bronchoscopy or endotracheal suction, which can be easily performed through the endotracheal tube in patients on IVL. In patients with a worsening condition and not responding to broad-spectrum antibiotics, the study should include staining for mycobacteria and for fungi and crops.
Additional studies are appointed under certain circumstances. People with a risk of legionellosis pneumonia (for example, patients who smoke have chronic lung diseases, the age is older 40 years old, receive chemotherapy or take immunosuppressants for organ transplantation) should carry out a urine test for Legionella antigens, which remains positive for a long time after the initiation of treatment, but allows the identification of only L pneumophila serogroup 1 (70% of cases).
A fourfold increase in antibody titers up to>: 28 (or in a single serum upon recovery>: 56) is also considered diagnostic. These tests are specific (95-100%), but not very sensitive (40-60%); Thus, a positive test indicates an infection, but a negative test does not exclude it.
Babies and small children with a possible RSV infection should be promptly examined for antigens in swabs from the nose or throat. There are no other tests for viral pneumonia; Viral culture and serological tests are rarely available at the clinic.
The PCR test (for mycoplasma and chlamydia) is not yet available, but it has good prospects due to its high sensitivity and specificity, as well as speed of execution.
The SARS-associated coronavirus test exists, but its role in clinical practice is unknown, and its use is limited beyond known outbreaks. In rare situations it is necessary to consider the possibility of anthrax.
What it is necessary to survey?Lungs
How to inspect?X-ray of the lungs Examination of the respiratory (lung) organs Computed tomography of the chest Study of bronchi and trachea
What tests are needed?Sputum analysis General blood analysis Antibodies to pneumococcus in serum Antistreptolysin O in serum Antibodies to streptococcus A, B, C, D, F, G in the blood Staphylococcal infections: antibodies to staphylococci in the blood serum Respiratory mycoplasmosis: detection of the Mycoplasma pneumoniae antigen in the direct immunofluorescence Mycoplasma infection: detection of mycoplasmas Chlamydia: detection of Chlamydia trachomatis Influenza A: antibodies to the influenza A and B virus in the blood Antibodies to cytomegalovirus class IgM and IgG in the blood Cytomegalovirus infection: detection of cytomegalovirus HIV / AIDS test HIV infection: detection of the immunodeficiency virus human (PCR vich)
Who to contact?Pulmonologist
Treatment of pneumonia
Risk assessment is carried out to identify those patients who can safely be treated on an outpatient basis and those who require hospitalization because of a high risk of complications. Prediction should reinforce, not replace, clinical data, as the choice of location of treatment is affected a host of invaluable factors - compliance, ability to self-service and the desire to avoid hospitalization. Hospitalization in OITR is required for patients who need artificial ventilation, and patients with arterial hypotension (systolic blood pressure <90 mm Hg. st.). Other hospitalization criteria in PIT include a respiratory rate of more than 30 / min, PaO2 / on inhaled O2 (PO2) less than 250, multi-lobe inflammation of the lung tissue, diastolic blood pressure less than 60 mm gt; st., confusion and urea of blood more than 1, mg / dl. Adequate treatment includes the fastest possible initiation of antibiotic therapy, preferably no later than 8 hours after the onset of the disease. Supportive treatment of pneumonia includes fluids, antipyretic and analgesic drugs and O2 for patients with hypoxemia.
Because microorganisms are difficult to identify, antibiotics are selected taking into account the likely pathogens and severity of the disease. Agreed recommendations have been developed by many professional organizations. Recommendations should be adapted to the local characteristics of the sensitivity of pathogens, the available drugs and the individual characteristics of the patient. It is important that none of the guidelines have recommendations for the treatment of viral pneumonia.
In bronchiolitis in children caused by RSV, ribavirin and specific immunoglobulin are used in monotherapy and in combination, but data on their effectiveness are inconsistent. Ribavirin is not used in adults with RSV infection. Amantadine or rimantadine orally at a dose of 200 mg once a day, taken within 48 hours of the onset of the disease, reduce the duration and severity symptoms in patients with suspected influenza during the epidemic, but effectiveness in terms of preventing unwanted outcomes of influenza pneumonia is unknown. Zanamivir (10 mg in the form of inhalation twice a day) and oseltamivir (orally 2 times a day for 75 mg, with an extremely severe flow of 2 times 150 mg) are equally effective in reducing duration of symptoms caused by influenza A or B if the reception is started within 48 hours of the onset of symptoms, although zanamivir may be contraindicated in patients with bronchial asthma. Acyclovir 5-10 mg / kg intravenously every 8 hours for adults or 250-500 mg / m2 body surface intravenously every 8 hours for children protects against infection of the lung caused by the varicella virus. If the patient does not begin treatment with antiviral drugs in the first 48 hours from the onset of the disease, then they should be used and to patients with the flu 48 hours after the onset of the disease. Some patients with viral inflammation of the lung tissue, especially those with influenza, develop additional bacterial infections and require antibiotics directed against S. pneumoniae, N. influenzae and Staphylococcus aureus. With empirical therapy, the condition of 90% of patients with bacterial pneumonia improves, which is manifested by a decrease coughing and shortness of breath, normalizing the temperature, reducing pain in the chest and reducing the number of white blood cells. The lack of improvement should cause suspicion of an atypical microorganism, resistance to an antibiotic with an inadequate spectrum action, co-infection or superinfection with a second pathogen, obstructive endobronchial lesion, immunosuppression, distant foci of infection with repeated infection (in the case of pneumococcal infection) or insufficient adherence to treatment (in the case of outpatients). If none of these causes is confirmed, failure of treatment is likely to result from inadequate immune protection.
Treatment for pneumonia of the viral origin is not carried out, since most viral pneumonia is resolved without it.
Patients older than 35 years after 6 weeks after treatment should undergo a second X-ray study; Preservation of an infiltrate causes suspicion of a possible malignant endobronchial formation or tuberculosis.
In addition to treatmentPhysiotherapy for pneumonia What to do with pneumonia? Antibiotics for pneumonia Than to treat? Zaxter Paxeladine R-Cynex Saironem Tavanik Fagotsef Fazizhin Hailefloqs Cebopim Zedex Thyme Herb Galavit
Some forms of community-acquired inflammation of the pulmonary tissue can be prevented by the use of pneumococcal conjugate vaccine (for patients <2 years), N. influenzae B (HIB) vaccine (for patients <2 years) and influenza vaccine (for patients> 65 years of age). Pneumococcal, HIB and influenza vaccine are also recommended for high-risk patients. High risk patients not vaccinated against influenza can be prescribed amantadine, rimantadine or oseltamivir during flu epidemics.
The status of candidates for outpatient treatment usually improves within 24-72 hours. The state of hospitalized patients may improve or worsen, depending on the concomitant pathology. Aspiration is the main risk factor for death, as well as the elderly age, the amount and nature of concomitant pathology and certain pathogens. Death can be caused by pneumonia itself, by progression to a septic syndrome that damages other organs, or by aggravation of underlying co-morbidities.
Pneumococcal infection still causes approximately 66% of all fatal cases of community-acquired pneumonia with a known pathogen. The total mortality in hospitalized patients is approximately 12%. Adverse prognostic factors include age less than 1 year or older than 60 years; involving more than one share; the content of leukocytes in peripheral blood is less than 5000 / μL; concomitant pathology (heart failure, chronic alcoholism, hepatic and renal insufficiency), immunosuppression (agammaglobulinemia, anatomical or functional asplenism), infection with serotypes 3 and 8, and hematogenous spread with positive blood cultures or with extrapulmonary complications (arthritis, meningitis or endocarditis). Infants and children are in a group of special risk for pneumococcal otitis media, bacteremia and meningitis.
Lethality in legionella infection is 10-20% among patients with community-acquired pneumonia and is higher among immunosuppressive or hospitalized patients. Patients who respond to treatment recover very slowly, radiologic changes usually persist for more than 1 month. Most patients require hospitalization, many require respiratory ventilation support and 10-20% die, despite adequate antibiotic therapy.
Mycoplasma pneumonia has a favorable prognosis; almost all patients recover. Chlamydia pneumoniae responds slower to treatment than mycoplasma, and tends to recur after premature discontinuation of treatment. People of young age usually recover, but mortality among the elderly reaches 5-10%.
Antibiotics for pneumonia
Antibiotics for pneumonia - the main component of the healing process. Lung inflammation begins acutely, with fever, a strong cough with brown or yellowish sputum, chest pains with coughing and breathing.
Treatment of pneumonia requires an urgent hospitalization of the patient in the therapeutic or resuscitation department (depending on the severity of the condition). Indicated bed rest, vitamin nutrition, and it is also important to consume a large amount of liquid - tea, juice, milk, mineral water.
Since inflammation of the lung tissue most often occurs due to specific microorganisms, the most correct way to fight the pathogen is the introduction of antibiotics intramuscularly and intravenously. This method of administration makes it possible to keep a high concentration of antibiotic in the blood, which contributes to the fight against bacteria. Most often, pneumonia is prescribed antibiotics of a wide spectrum of action, since it is impossible to identify the pathogen immediately, and the slightest delay can cost lives.
In general, for the treatment of pneumonia, macrolides (azithromycin, clarithromycin, midecamycin, spiramycin) and fluoroquinolone antibiotics (moxifloxacin, levofloxacin, ciprofloxacin). To increase the effectiveness of treatment, antibiotics are administered according to a special scheme. At the first stage, the antibiotic is administered parenterally - intramuscularly or intravenously, and then antibiotics are given in tablets.
Despite the wide choice of antibiotics in pharmacies, you should not self-medicate, but it is better to seek help from experienced specialist, since antibiotics are selected strictly individually, based on the analysis of the pathogen pneumonia. In addition, the treatment of pneumonia is based not only on antibiotic therapy, but includes several stages in the general treatment regimen.
What antibiotics for pneumonia will be most effective is established laboratory. To do this, bacterial culture of sputum is done on a special medium, and depending on which colony of bacteria begins to develop, the causative agent is established. Then they make a test for the sensitivity of the pathogen to antibiotics, and based on these results, the patient is assigned a specific group of antibacterial drugs. But, as the process of identifying the pathogen can take up to 10 days or more, at the initial stage of treatment of pneumonia, the patient is prescribed broad-spectrum antibiotics. To maintain the concentration of the drug in the blood, it is administered by both intravenous and intramuscularly, combining with anti-inflammatory, resolving agents, vitamins, etc., eg:
- Streptococcus pneumoniae. In antipnevmokokkovoy therapy prescribed benzylpenicillin and aminopenicillin, derivatives of cephalosporins of the third generation, such as cefotaxime or ceftriaxone, macrolides.
- Haemophilus influenzae. With the detected hemophilic rod, aminopenicillins or amoxicillin are prescribed.
- Staphylococcus aureus. Antibiotics effective against Staphylococcus aureus - oxacillin, protected aminopenicillins, cephalosporins I and II generations.
- Mycoplasma pneumoniae, Chlamydia pneumoniae. Antibiotics for the treatment of mycoplasmal and chlamydial pneumonia are macrolides and tetracycline antibiotics, as well as fluoroquinolones.
- Legionella pneumophila. Antibiotic, effective against legionella - erythromycin, rifampicin, macrolides, fluoroquinolones.
- Enterobacteriaceae spp. Antibiotics for the treatment of pneumonia caused by klibsiella or E. coli are cephalosporins of the third generation.
Treatment of pneumonia after antibiotics
Treatment of pneumonia after antibiotics can be the reason for the selection of ineffective drugs or if the intake of antibacterial agents is not taken properly - an incorrect dosage, a violation of the regimen. In normal course, antibiotics are taken to normalize the temperature and then after 3 more days. In severe cases of pneumonia, treatment may take up to 4-6 weeks. If during this period the positive dynamics of the disease is not fixed, then the cause is in the wrong antibacterial treatment. In this case, a second analysis is performed on the bacteria, after which a course of correct antibacterial therapy is conducted. After full recovery and positive results of radiography, spa treatment, smoking cessation, and increased vitamin nutrition are indicated.
In the additional treatment with antibiotics after pneumonia, the patient may need to:
- Wrongly chosen antibiotic for treatment.
- Frequent change of antibiotics.
Also, antibiotic treatment after pneumonia may be necessary in the event of a recurrence of the disease. The reason for this - long-term treatment with antibiotics, depressing the defenses of the body. Also, a similar result arises from self-medication and uncontrolled administration of antibiotics at unidentified doses.
Treatment of pneumonia after antibiotics should be carried out in a hospital, by systematic radiographic monitoring. If after 72 hours the clinical picture does not change or if during the treatment termination the focus of inflammation on X-ray image is not reduced, a second course of treatment is shown, but already with another antibiotic, consultation is also necessary phthisiatrician.
Antibiotics for pneumonia in adults
Antibiotics for pneumonia in adults are prescribed depending on the age of the patient and the severity of the condition. Pneumonia is most often caused by a variety of bacteria, less often fungi and protozoa. At the first stage of treatment, up to the end results, antibiotics of a wide spectrum of action are prescribed, and also patient, whether he had previously had pneumonia, tuberculosis, diabetes, chronic bronchitis, is not smoker. In addition, in elderly patients, pathogens differ from similar cases in younger patients.
If the prescribed drug is ineffective and until the bacteriological analysis of sputum is obtained, the recommended antibiotic should not be changed within 3 days. This is the minimum time frame for the antibiotic concentration in the blood to reach its maximum, and it began to act on the lesion site.
- Inflammation of the lungs in patients under 60 years with a mild course appoint Avelox 400 mg per day (or Tavanik 500 mg in day) - 5 days, with him Doxycycline (2 tablets per day - the first day, the rest days - 1 tablet) - 10-14 days. You can take Avelox 400 mg and Amoxiclav 625 mg * 2 times a day - 10-14 days.
- A patient under 60 years of age, with a major illness and other chronic diseases, also a patient over 60 years old are assigned Avelox 400 mg plus Ceftriaxone 1 gram 2 times a day at least 10 days.
- Severe course of pneumonia at any age. A combination of Levofloxacin or Tavanic, intravenously plus Ceftriaxone 2 grams twice a day or Fortum, Cefepime in the same doses intramuscularly or intravenously is recommended. It is possible to administer Sumamed intravenously plus Fortum intramuscularly.
- In extremely severe pneumonia, when the patient is hospitalized in the intensive care unit, appoint: combinations of Sumamed and Tavanik (Leflotsin), Fortum and Tavanik, Targotsida and Meronem, Sumamed and Meronema.
Antibiotics for pneumonia in children
Antibiotics for pneumonia in children begin to enter immediately after confirmation of the diagnosis. Obligatory admission to therapy or in a complex current in the intensive care unit are children, if:
- The child's age is less than two months, regardless of the degree of severity and localization of the inflammatory process in the lungs.
- A child up to three years old, diagnosed with lobar pneumonia.
- The child is up to five years old, the diagnosis is the loss of more than one lobe of the lung.
- Children with a history of encephalopathy.
- A child up to a year old, a confirmed fact of intrauterine infection.
- Children with congenital defects of the heart muscle and circulatory system.
- Children with chronic diseases of the respiratory system, cardiovascular system, kidneys, with diabetes mellitus and malignant blood diseases.
- Children from families who are registered with social services.
- Children from orphanages, from families with insufficient social and living conditions.
- The hospitalization of children with non-compliance with medical recommendations and treatment at home is indicated.
- Children with severe pneumonia.
With mild bacterial pneumonia, antibiotics from the penicillin group, both natural and synthetic, are indicated. Natural antibiotics: benzylpenicillin, phenoxymethylpenicillin, and others. Semisynthetic penicillins are commonly divided into isoxazolylpenicillins (oxacillin), aminopenicillins (ampicillin, amoxicillin), carboxypenicillins (carbenicillin, ticarcillin), ureidopenicillins (azlocillin, piperacillin).
The described scheme of antibiotic treatment of pneumonia in children is prescribed until the results of bacterial analysis and detection of the pathogen. After identifying the pathogen further treatment is prescribed by the doctor strictly individually.
Names of antibiotics for pneumonia
The names of antibiotics for pneumonia indicate which group the drug belongs to: ampicillin - oxacillin, ampiox, piperacillin, carbenicillin, ticarcillin, cephalosporins - claforan, cephobid and others. For the treatment of pneumonia in modern medicine are used as synthetic and semi-synthetic, and natural antibiotics. Some types of antibiotics act selectively, only on a certain type of bacteria, and some on a fairly wide range of pathogens. It is with antibiotics of a wide spectrum and it is customary to start antibacterial treatment of pneumonia.
Rules for prescribing antibiotics for pneumonia:
An antibacterial preparation with a wide spectrum of action is prescribed, proceeding from the course of the disease, the color of expectorated sputum.
- Conduct BAC sputum analysis to identify the pathogen, put the test on the sensitivity of the pathogen to antibiotics.
- Prescribe a scheme of antibiotic therapy based on the results of the analysis. In this case, take into account the severity of the disease, the effectiveness, the likelihood of complications and allergies, possible contraindications, the rate of absorption of the drug into the blood, the time of excretion from organism. Most often, two antibacterial drugs are prescribed, for example, an antibiotic group of cephalosporins and fluoroquinolones.
Hospital pneumonia is treated with amoxicillin, ceftazidime, with inefficiency - ticarcillin, cefotaxime. Also a combination of antibiotics is possible, especially in severe conditions, mixed infection, weak immunity. In such cases, appoint:
- Cefuroxime and gentamicin.
- Amoxicillin and gentamicin.
- Lincomycin and amoxicillin.
- Cephalosporin and lincomycin.
- Cephalosporin and metronidazole.
With community-acquired pneumonia, azithromycin, benzylpenicillin, fluoroquinolone are prescribed, in severe conditions - cefotaxime, clarithromycin. Combinations of the listed antibiotics are possible.
Independently to change a line of treatment by antibiotics it is not necessary, so it can lead to development of stability microorganisms to certain groups of drugs, as a result - inefficiency of antibacterial therapy.
Course of antibiotics for pneumonia
The course of antibiotics for pneumonia is prescribed by the attending physician, based on the patient's age, severity of the disease, the nature of the pathogen and the body's response to antibacterial therapy.
In severe community-acquired pneumonia, the following treatment is prescribed:
- Aminopenicillins - amoxicillin / clavulanate. Children at an early age are prescribed with aminoglycosides.
- Possible treatment options:
- Ticarcillin antibiotics
- Cephalosporins of II-IV generations.
With aspiration bacterial pneumonia, the following antibiotics are prescribed:
- Amoxicillin or clavulanate (Augmentin) intravenously + aminoglycoside.
- Possible variants of the treatment regimen, purpose:
- Metronidazole + cephalosporins III pen.
- Metronidazole + cephalosporins III n-y + aminoglycosides.
- Lincosamides + cephalosporins III pen.
- Carbapenem + vancomycin.
With nosocomial pneumonia, the following antibiotics are prescribed:
- With an easy course of pneumonia, the use of protected aminopenicillins (Augmentin).
- Possible variants of the treatment regimen are the appointment of cephalosporins II-III n-th.
- In severe cases, combined treatment is required:
- inhibitor-protected carboxypenicillins (ticarcillin / clavulanate) and aminoglycosides;
- cephalosporins III n-i, cephalosporins IV n-y with aminoglycosides.
Treatment of pneumonia, a long and serious process and attempts at self-medication with antibiotics not only can lead to complications, but and cause the impossibility of correct antibacterial therapy due to the low sensitivity of the pathogen to drug.
Treatment of pneumonia with antibiotics caused by Klebsiella
When found in sputum Klibsiella pneumonia treatment with antibiotics is the main method of pathogenic therapy. Klebsiella - a pathogenic microorganism, normally occurs in the human intestine, and with high concentration and a decrease in immunity can cause lung infections. Approximately 1% of cases of bacterial pneumonia are caused by Klebsiella. Most often, such cases are recorded in men over 40, patients with alcoholism, with diabetes, chronic bronchopulmonary diseases.
The clinical course of pneumonia caused by klibsiella is similar to pneumococcal pneumonia, often the focus of inflammation is localized in the right upper lobe of the lung, it can spread to other lobes. Develops cyanosis, shortness of breath, jaundice, vomiting, diarrhea. Often, pneumonia is complicated by abscess and empyema lung, the reason is that the klibsiella are the cause of tissue destruction. With community-acquired pneumonia, Klebsiella, Serratia and Enterobacter are found in sputum.
Klebsiella, Serratia and Enterobacter have a different degree of sensitivity to antibiotics, so treatment begins with the designation of aminoglycosides and cephalosporins of the third generation, mezlocillin, amikacin is effective against the Serratia strain.
With proper and timely treatment, pneumonia caused by klibsiella, without complications, is completely cured in 2-3 weeks.
Treatment of severe pneumonia caused by klibsiella, appoint aminoglycosides (tobramycin, gentamicin from 3 to 5 mg / kg per day) or amikacin 15 mg / kg per day with cephalothin, cefapyrin, 4 to 12 g in day. Treatment of severe pneumonia caused by klibsiella, appoint aminoglycosides (tobramycin, gentamicin from 3 to 5 mg / kg per day) or amikacin 15 mg / kg per day with cephalothin, cefapyrin, 4 to 12 g in day.
Treatment with antibiotics mycoplasmal pneumonia
If a mycroplasma is detected in the sputum, pneumonia is treated to fight a particular pathogen. Getting into the body, mycoplasma is introduced into the mucous membrane of the upper respiratory tract, where secreting a special secret causes first a strong inflammation, and then begins the destruction of intercellular membranes, epithelial tissues, which ends with necrotic degeneration tissue.
In the pulmonary vesicles, mycoplasma rapidly multiply, the alveoli increase, and possibly the interalveolar septa. Mycoplasmal pneumonia develops slowly, the onset of the disease looks like a cold, then the temperature rises to 39-40 degrees, a violent cough begins. The temperature lasts about 5 days, then drops sharply, fixing at around 37-3 degrees, and holds for a long time. On the X-ray image clearly visible darkened foci, degeneration in connective tissue septums.
The difficulty of treating mycoplasmal pneumonia is that the pathogen is inside neutrophils, and this makes penicillins, cephalosporins and aminoglycosides ineffective. First of all, macrolides are prescribed: azithromycin (sumamed), spiromycin (rovamycin), clarithromycin, applied 2 times a day, no more than 2 weeks, with a smaller rate of relapse.
Antibiotics for congestive pneumonia
Antibiotics for congestive pneumonia appoint a course of at least 2 weeks. Congestive pneumonia develops with prolonged bed rest, in elderly people, weakened, as well as complication after complicated operations. The flow of congestive pneumonia is slow, asymptomatic, there is no chill, fever, cough. The patient can be disturbed only by shortness of breath and weakness, drowsiness, later there is a coughing.
To treat congestive pneumonia it is possible and at home, but adhering to all prescriptions, and only under the control of a doctor, so most often the patient is hospitalized in a hospital. If a bacterial infection is found in the sputum (congestive pneumonia does not always have a bacterial character), antibiotics - cefazolin, digitum or protected penicillin - are prescribed. The course of treatment is 2-3 weeks.
With congestive pneumonia, developing against a background of heart failure, additionally prescribed glycosides and diuretic medicinal complexes, along with antibacterial, bronchodilator, expectorant means. In addition, therapeutic exercise is shown, a diet rich in vitamins. With aspiration pneumonia, bronchoscopy is mandatory.
In general, with a timely diagnosis and antibiotic therapy, quality prevention and maintaining the patient's body, complications with congestive pneumonia does not develop, and recovery comes through 3-4 weeks.
Combination of antibiotics in pneumonia
The combination of antibiotics in pneumonia is introduced by the doctor into the treatment regimen under certain conditions that aggravate the clinic. In the clinic, the use of two or more antibiotics is not approved, due to the high burden on the body - the liver and kidneys of a weakened person can not cope with so many toxins. Therefore, in practice, the treatment of pneumonia with a single antibiotic, whose effect on the pathogenic flora is very high, is acceptable.
Combinations of antibiotics for pneumonia are acceptable when:
- Severe course of pneumonia, with secondary pneumonia.
- Mixed infection.
- Infections with oppressed immunity (with cancer, lymphogranulomatosis, use of cytostatics).
- Dangers or development of resistance to the selected antibiotic.
In such cases, a treatment regimen is developed, based on the introduction of antibiotics that affect Gram-positive and Gram-negative microorganisms - penicillins + aminoglycosides or cephalosporins + aminoglycosides.
Do not engage in self-medication, as the necessary dosage of the drug can be prescribed only by a doctor, and with insufficient doses of antibiotic simply the resistance of microorganisms to the drug will develop, and at too high a dose cirrhosis, renal dysfunction, dysbiosis, severe form of anemia. In addition, some antibiotics for pneumonia, when combined, simply reduce the effectiveness of each other (for example, antibiotics + bacteriostatic drugs).
Best antibiotic for pneumonia
The best antibiotic for pneumonia is one to which the bacteria are most sensitive. For this purpose, special laboratory tests are carried out - bacteriological sprouting of the sputum is done to determine the pathogen and then put the test on sensitivity to antibiotics.
The main direction in the treatment of pneumonia is antibacterial therapy. Until the pathogen is identified, antibiotics of a wide spectrum of action are prescribed. In case of community-acquired pneumonia, penicillin with clavulanic acid (amoxiclav, etc.), macrolides (rulid, rovamycin, etc.), cephalosporins of the 1st generation (kefzon, cefazolinum, tsoufalexin, etc.) are prescribed.
At hospital pneumonia appoint: penicillin in clavulanic acid, cephalosporins of the 3rd generation (klaforan, ceftide, fortum, etc.), fluoroquinolones (peflacin, ciprobai, taravid, etc.), aminoglycosides (gentamicin), carbapenems (thienes).
The full complex of therapy consists not only of a combination of antibiotics (2-3 species), but also directed to restoration of drainage of bronchi (introduction of euphyllinum, beroduala), for liquefaction and excretion of sputum from bronchi. Also inject anti-inflammatory, absorbable drugs, vitamins and components that stimulate the immune system - freshly frozen plasma intravenously, antistaphylococcal and anti-influenza immunoglobulin, interferon and etc.
Modern antibiotics for pneumonia
Modern antibiotics for pneumonia are prescribed according to a special scheme:
- With the predominance of gram-positive cocci, intravenous and intramuscular injections of penicillin or cephalosporin preparations of the 1 st, 2 nd generation - cefazolin, cefuroxime, cefoxine.
- With the predominance of Gram-negative bacteria, cephalosporins of the third generation, cefotaxime, ceftriaxone, ceftazidime, are prescribed.
- Atypical course of pneumonia appoint macrolides - azithromycin, midekamycin, as well as cephalosporins of the third generation - ceftriaxone, ceftazidime, etc.
- With the predominance of gram-positive cocci, methicillin-resistant staphylococci or enterococci, cephalosporins of the 4th generation - cefipin, carbapines - to thienes, meronem, etc., are prescribed.
- With the predominance of multidrug-resistant gram-negative bacteria, cephalosporins of the third generation-cefotaxime, ceftriaxone, ceftazidime, are additionally prescribed aminoglycosides.
- With the prevalence of fungal infection, cephalosporins of the third generation plus fluconazole are prescribed.
- With the predominance of intracellular organisms - mycoplasma, legionella, etc. appoint macrolides - azithromycin, clarithromycin, roxithromycin, etc.
- In case of anaerobic infection, inhibitor-protected penicillins-lincomycin, clindamycin, metronidazole, and others-are prescribed.
- With penvmotsistnoy pneumonia appoint cotrimoxazole and macrolides.
- With cytomegalovirus pneumonia, ganciclovir, aciclovir, and cytotect are prescribed.
Antibiotics for pneumonia. Treatment of pneumonia with antibiotics in adults and children
Inflammation of the lungs is a disease that occurs in both adults and very young children. The causative agents are viruses, bacteria, other microorganisms. The main danger that can be expected from a given ailment is an extremely difficult physical condition and even a lethal outcome. That is why therapy should be timely. In general, the treatment of pneumonia with antibiotics is practiced.
How pneumonia develops. Classification
Most often, this disease occurs because of the entry into the respiratory tract of pathogenic microflora: staphylococci, pneumococci, Legionella, Escherichia coli and others. In this case, inflammatory processes in the tissues of the respiratory system develop. Lung inflammation can also be caused by viral infections, and some toxic substances, rarely pneumonia is a consequence of a chest injury. There is a risk group, which includes smokers, people who abuse alcohol, patients who are in bed for a long time, as well as elderly people. Depending on the type of pathogen distinguish bacterial, viral, fungal and mixed pneumonia. If one lung is affected, then one-sided inflammation is indicated. There can also be bilateral, total, share, segmental pneumonia. Depending on the epidemiological data, the disease is nosocomial, community-acquired, atypical, and also caused by immunodeficiency.
The main symptoms of the disease
One of the main symptoms in the development of inflammatory processes in the lungs is cough. Also, when breathing can feel a characteristic pain, there is shortness of breath. Especially acute are painful sensations with deep breaths, coughing. At a pneumonia the high temperature of a body is observed. However, not always the inflammation of the lungs is accompanied by its increase. The patient feels weakness in the entire body, fatigue, decreased appetite, nausea and even vomiting is possible. Symptoms are especially severe in older people and children. All this suggests that to ease the condition and to avoid the development of complications, it is necessary to start taking antibiotics for pneumonia. This disease has a special feature: antibacterial drugs are prescribed immediately, without waiting for laboratory tests. After receiving the results of sputum analysis, treatment is adjusted.
Stages of the course of the disease
Specialists distinguish three degrees of severity of inflammation of the respiratory system. The mild stage is characterized by mild intoxication, body temperature is within 38 ºС, heartbeat is not accelerated. In this case, the person retains a clear consciousness. At the X-ray examination, a small affected area is found. At a more severe degree, the temperature can increase to 39 ° C, intoxication is more pronounced. There is a moderate tachycardia, there is shortness of breath. X-ray images clearly show infiltration. The heaviest degree is characterized not only by the high temperature (up to 40 ºС), but also by the cloudiness of the mind. A person can be delirious, breath comes even in a calm state. At the same time, intoxication of the body is clearly pronounced.
Antibiotic for pneumonia in adults
This group of drugs is aimed at the destruction of pathogenic flora. The first thing a specialist should do is to suppress the acute symptoms of the disease. In this case, antibiotics are prescribed, which have a wide spectrum of action.
Then the doctor sends a sample of phlegm to the laboratory. The results of the studies influence the further treatment. A specific pathogen that provoked the disease is established. The specialist chooses the necessary antibiotic for pneumonia in adults, whose action will be directed to the destruction of this microorganism. A combination of drugs is often required, as there may be several pathogens. For a competent selection of drugs, use an antibioticogram.
This analysis helps to determine whether the patient's body is sensitive to a particular antibiotic. After all, the market is saturated with all sorts of drugs, and often bacteria show resistance to one type of medication, but are destroyed under the influence of another. For the study, the patient needs sputum. The sample is exposed to different preparations. In this analysis, the most effective antibiotics for pneumonia for a particular patient are selected. They will suppress the growth of microorganisms. Weaker drugs will not interfere with their development. The accuracy of such an investigation is high. The only drawback is that it takes a long time to wait for the results: they will be ready after 2-5 days.
Groups of antibiotics used in the treatment of pneumonia
The most common treatment for pneumonia with antibiotics begins with a wide-spectrum drugs. These include penicillins, macrolides, tetracyclines, fluoroquinols, aminoglycosides, cephalosporins.
Penicillins are one of the first antibacterial drugs. They are natural and semi-synthetic. Well penetrate into body fluids and tissues. Can cause and a number of undesirable phenomena: diarrhea, hypersensitivity, allergic reactions. Treatment of pneumonia with antibiotics of this type is effective if the pathogens are streptococci, staphylococci.
Tetracyclines are drugs that are used less and less. The reason for this is the resistance of microorganisms to their action. Also, the peculiarity of the drugs lies in their ability to accumulate in the tissues of the bones. In this case, they can lead to the destruction of teeth. Therefore, such antibiotics for pneumonia are not prescribed to pregnant women, women during lactation, young children, and also to patients who have kidney problems. Representatives of preparations of tetracycline group - "Doxycycline "Tetracycline".
There are 4 generations of this type of medicine. To preparations of the first generation carry "Цефазолин "Цефалексин etc. They are active on the bacteria of the coccus group (pneumococci, staphylococci). The second generation of drugs has good antibacterial properties in relation to both gram-positive and gram-negative flora. The half-life period is approximately 1 hour. Cephalosporins, which belong to the third generation, have an excellent effect on microorganisms that are resistant to penicillin group drugs ("Cefotaxime "Cefoperazone"). They are used to treat severe forms of infections. Cefepim - the name of antibiotics for pneumonia of the fourth generation. They are the most active. Among the adverse reactions after taking cephalosporins, the allergy is most often identified. About 10% of patients note the presence of allergic reactions to these drugs.
Macrolides are used to neutralize cocci, legionella, chlamydia. They are well absorbed into the body, but eating somewhat slows down the process. Allergic reactions are very rare. Representatives of this category are such drugs as "Erythromycin "Azithromycin "Clarithromycin". The main area of their application is infectious processes in the respiratory tract. However, a contraindication to taking such drugs is a violation in the liver.
Aminoglycosides are antibiotics for pneumonia, which actively affect aerobic gram-negative microorganisms. They are also used in cases when the disease is caused not by one type of bacteria, and therefore it is necessary to combine antibacterial drugs to achieve the desired result. Representatives of the group are such drugs as "Gentamicin "Amikacin". Dosage is calculated depending on the patient's body weight, age, severity of the disease. When taking such drugs, you need control over the glomerular filtration in the kidneys.
Class of quinols and fluoroquinols
Medicines of this category are divided into 4 generations. Non-fluorinated (this is the first generation) actively affect Legionella, Escherichia coli. Somewhat less they affect chlamydia, cocci. Preparations of the first generation are used for light infections. The remaining quinols (from the second to the fourth generation) are fluorinated. All drugs are well distributed in the body. They are excreted from the body mainly by the kidneys. The main contraindications for use are the period of bearing of the child, increased sensitivity to the drug. In addition, it is undesirable to use non-fluorinated drugs to patients who have impaired liver and kidney function. Fluoroquinols are not prescribed for children (under 18 years of age). The only exception is the absence of an alternative. This class includes such drugs as "Ciprofloxacin "Pefloxacin "Levofloxacin". Intravenously, these medications are administered only drip.
What are the rules for prescribing antibacterial drugs?
If pneumonia is diagnosed, which antibiotics to take, only the specialist decides. After the beginning of the use of drugs, they can be replaced by others. Indications for this are serious side effects that can occur with the treatment of certain drugs. Also, the replacement occurs if the doctor does not observe the desired result (and the changes for the better should appear already on the second or third day). Some antibiotics are quite toxic. Therefore, their reception can not be long. In general, the treatment of pneumonia in adults with antibiotics lasts 10 days. But more serious infections require significantly more time (about a month). The specialist must take into account the general condition of the patient, and the presence of certain concomitant and chronic diseases, the age of a person. When prescribing antibacterial drugs, it is also important to create a dose of the drug in the blood, which will be sufficient precisely for a given severity of the disease.
In what forms are antibiotics used
Depending on the stage of the disease and the severity of its course, different methods of drug administration are used. Basically, in the early days of the disease, drugs are injected. Cephalosporin (antibiotics for pneumonia) injections are administered intravenously or intramuscularly. This is possible due to their low toxicity. A feature of macrolides is that they accumulate and continue to act even when the medication is stopped. The mild forms of the disease are treated within 10 days. In this case, antibiotics can be used for pneumonia in tablets. However, experts argue that the oral form of taking medicines is not so effective. This is because it is difficult to calculate the exact dosage. It is not recommended to change preparations frequently, since this can develop the resistance of microorganisms to antibiotics.
Features of treatment of pneumonia in children
Especially dangerous is pneumonia for young patients. A disease can even occur in toddlers. The main symptoms of pneumonia in small patients are wheezing, coughing, shortness of breath and frequent breathing, high fever (which lasts quite a long time). It is worth paying attention to the behavior of the baby. He loses his appetite, becomes sluggish, restless. The most important symptom of pneumonia in young children is the blueing of the area between the lips and nose. As a rule, there is pneumonia as a complication after an acute respiratory viral infection, and not as an independent disease. There are also congenital pneumonia (causative agent - herpes virus, mycoplasma), infection can occur directly during or after childbirth. In newborns, the airways are small, the gas exchange is less intense. Therefore, the disease is more severe.
Antibiotics and children
As for adults, antibiotics are the basis of therapy for pneumonia in children. When pneumonia in children, they are administered parenterally. This makes it possible to minimize the effects of drugs on the microflora of the digestive system. It is also possible to take drugs in the form of injections or inhalations. The last method is the most comfortable for young children. If the child's age does not exceed 6 months, then the treatment is performed exclusively in the hospital, where the baby is under the constant supervision of specialists. The course of therapy for children is 7 days in case of taking penicillin group drugs, cephalosporins. If the doctor prescribed macrolides (this may be "Azithromycin "Clarithromycin"), then the duration of treatment is reduced to 5 days. Antibiotics for pneumonia in children should show efficacy within 3 days. Otherwise, it is possible to replace the drug.
Do not self-medicate. Even the best antibiotics for pneumonia, which helped one child, for another can be ineffective, and even completely dangerous. It is very important to strictly adhere to the schedule of taking medications. It is impossible to take synthetic vitamins and other immunomodulating agents in parallel. To prevent the onset of pneumonia, it is necessary to avoid hypothermia of the body, to timely treat colds and other infectious diseases. Do not forget about the right balanced diet.