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.
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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.
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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:
- 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 also cause the impossibility of correct antibacterial therapy due to the low sensitivity of the pathogen to the drug.
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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.
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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).
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