^

Health

Antibiotics for pneumonia

, medical expert
Last reviewed: 19.10.2021
Fact-checked
х

All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.

If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.

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 pain when 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, macrolides (azithromycin, clarithromycin, midecamycin, spiramycin) and fluoroquinolone antibiotics (moxifloxacin, levofloxacin, ciprofloxacin) are widely used for the treatment of pneumonia. 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, it is not necessary to engage in self-medication, but it is better to seek help from an experienced specialist, since antibiotics are selected strictly individually, based on the analysis of the causative agent of 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 intramuscular injection, combining with anti-inflammatory, resorptive agents, vitamins, etc., for example:

  • 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.

trusted-source[1], [2], [3], [4], [5], [6], [7]

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 the focus of inflammation on the X-ray image does not decrease during the treatment, a second course of treatment is indicated, but already with another antibiotic, the phthisiatric consultation is also needed.

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 appointed, and also specify in the patient whether he had previously had pneumonia, tuberculosis, diabetes mellitus, chronic bronchitis, whether he is a 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 of age with a mild course appoint Avelox 400 mg per day (or Tavanik 500 mg per day) - 5 days, with it Doxycycline (2 tablets per day - the first day, the remaining 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, as well as a patient older than 60 years, is assigned Avelox 400 mg plus Ceftriaxone 1 gram 2 times a day for a minimum of 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, they are appointed: combinations of Sumamed and Tavanik (Leflotsin), Fortum and Tavanik, Targotsida and Meronem, Sumamed and Meronem.

trusted-source[8], [9], [10], [11], [12], [13], [14], [15], [16], [17]

Antibiotics for pneumonia in children

Antibiotics for pneumonia in children begin to enter immediately after confirmation of the diagnosis. Obligatory hospitalization in therapy or in difficult flow in the intensive care 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, etc. 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.

trusted-source[18], [19], [20], [21], [22]

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, cefobide, etc. For the treatment of pneumonia in modern medicine, both synthetic and semisynthetic 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 in the blood, the time of excretion from the body. 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.

It is not necessary to change the antibiotic treatment line independently, so this can lead to the development of resistance of microorganisms to certain groups of drugs, as a result - the ineffectiveness of antibiotic 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:

  1. Aminopenicillins - amoxicillin / clavulanate. Children at an early age are prescribed with aminoglycosides.
  2. Possible treatment options:
    •  Ticarcillin antibiotics
    • Cephalosporins of II-IV generations.
    • Fluoroquinolones

With aspiration bacterial pneumonia, the following antibiotics are prescribed:

  1. Amoxicillin or clavulanate (Augmentin) intravenously + aminoglycoside.
  2. 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:

  1. With an easy course of pneumonia, the use of protected aminopenicillins (Augmentin).
  2. Possible variants of the treatment regimen are the appointment of cephalosporins II-III n-th.
  3. 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 also cause the impossibility of correct antibacterial therapy due to the low sensitivity of the pathogen to the drug.

trusted-source[23], [24], [25], [26], [27]

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 is a pathogenic microorganism, normally found in the human intestine, and at high concentration and a decrease in immunity, it can cause pulmonary 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 appointment of aminoglycosides and cephalosporins of the third generation, mezlocillin, against the strain of Serratia is effective amikacin.

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 grams per 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 grams per 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 the intercellular membranes, epithelial tissues, which ends with the necrotic degeneration of the 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 sharply decreases, fixing at around 37-37.6 degrees and lasts 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. Stagnant 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 the background of heart failure, additionally prescribed glycosides and diuretic medicinal complexes, along with antibacterial, bronchodilator, expectorant. In addition, therapeutic exercise is shown, a diet rich in vitamins. With aspiration pneumonia, bronchoscopy is mandatory.

In general, with a timely diagnosis and antibacterial therapy, quality prevention and maintenance of the patient's body, complications with congestive pneumonia do not develop, and recovery occurs 3-4 weeks later.

trusted-source[28], [29], [30], [31]

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 administration of antibiotics that affect gram-positive and gram-negative microorganisms - penicillins + aminoglycosides or cephalosporins + aminoglycosides.

Do not engage in self-medication, as only the doctor can prescribe the necessary dosage of the drug, and with insufficient doses of antibiotic, the resistance of microorganisms to the drug will simply develop, and at too high a dose cirrhosis, renal dysbiosis, severe anemia can develop. In addition, some antibiotics for pneumonia, when combined, simply reduce the effectiveness of each other (for example, antibiotics + bacteriostatic drugs).

trusted-source[32], [33], [34], [35], [36], [37], [38], [39], [40]

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.

In hospital pneumonia, appoint: penicillin in clavulanic acid, cephalosporins of the 3rd generation (claforan, cephobid, fortum, etc.), fluoroquinolones (peflacin, ciprobai, taravid, etc.), aminoglycosides (gentamicin), carbapenems (thienam).

The full complex of therapy consists not only of a combination of antibiotics (2-3 species), but also aimed at restoring the drainage of the bronchi (the introduction of euphyllinum, beroduala), for liquefaction and excretion of sputum from the bronchi. Also inject anti-inflammatory, resorbants, vitamins and components that stimulate the immune system - freshly frozen plasma intravenously, antistaphylococcal and anti-influenza immunoglobulin, interferon, etc.

trusted-source[41], [42], [43], [44], [45], [46], [47]

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 3rd generation plus fluconazole are prescribed.
  • With the predominance of intracellular organisms - mycoplasma, legionella, etc., macrolides are prescribed - 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.

Attention!

To simplify the perception of information, this instruction for use of the drug "Antibiotics for pneumonia" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.

Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.

Translation Disclaimer: The original language of this article is Russian. For the convenience of users of the iLive portal who do not speak Russian, this article has been translated into the current language, but has not yet been verified by a native speaker who has the necessary qualifications for this. In this regard, we warn you that the translation of this article may be incorrect, may contain lexical, syntactic and grammatical errors.

You are reporting a typo in the following text:
Simply click the "Send typo report" button to complete the report. You can also include a comment.