Bacterial pneumonia medical therapy: Difference between revisions
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'''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com] Phone:617-632-7753; [[Philip Marcus, M.D., M.P.H.]][mailto:pmarcus192@aol.com] | '''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com] Phone:617-632-7753; [[Philip Marcus, M.D., M.P.H.]][mailto:pmarcus192@aol.com] | ||
==Overview== | ==Overview== | ||
Antimicrobial therapy is the mainstay of treatment for bacterial pneumonia. Patients with severe disease, comorbidities, and/or complications usually require hospitalization and multidrug therapy. | |||
==Medical Therapy== | ==Medical Therapy== | ||
[[Antimicrobials]]s are the treatment of choice for bacterial pneumonia. The choice of antibiotic depends on the nature of the pneumonia, the microorganisms most commonly causing pneumonia in the geographical region, and the immune status and underlying health of the individual. In the [[United Kingdom]], [[Amoxicillin]] is used as first-line therapy in the vast majority of patients who acquire pneumonia in the community, sometimes with added [[Clarithromycin]]. In North America, where the "atypical" forms of community-acquired pneumonia are becoming more common, [[Clarithromycin]], [[Azithromycin]], or [[fluoroquinolones]] as single therapy, have displaced [[Amoxicillin]] as first-line therapy. Local patterns of antibiotic-resistance should always be considered when initiating pharmacotherapy. In hospitalized individuals or those with immune deficiencies, local guidelines determine the selection of antibiotics. These antibiotics are typically given intravenously. | |||
===Treatment of gram-positive organisms=== | ===Treatment of gram-positive organisms=== | ||
*Streptococcus pneumoniae - [[ | *Streptococcus pneumoniae - [[Amoxicillin]] (or [[Erythromycin]] in patients allergic to penicillin); [[Cefuroxime]] and [[Erythromycin]] in severe cases. | ||
*Staphylococcus aureus - [[ | *Staphylococcus aureus - [[Flucloxacillin]] (to counteract the organism's β-lactamase) | ||
===Treatment of gram-negative organisms=== | ===Treatment of gram-negative organisms=== | ||
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===Treatment of atypical organisms=== | ===Treatment of atypical organisms=== | ||
Most atypical causes of pneumonia require treatment for 14-21 days. | Most atypical causes of pneumonia require treatment for 14-21 days. | ||
*Chlamydophila pneumoniae - [[ | *Chlamydophila pneumoniae - [[Doxycycline]] | ||
*[[Chlamydophila psittaci]] - [[ | *[[Chlamydophila psittaci]] - [[Erythromycin]] | ||
*Mycoplasma pneumoniae - [[ | *Mycoplasma pneumoniae - [[Erythromycin]] | ||
*Coxiella burnetti - [[ | *Coxiella burnetti - [[Erythromycin]] | ||
*[[Legionella pneumophila]]- [[ | *[[Legionella pneumophila]]- [[Erythromycin]], with [[Rifampicin]] sometimes added. | ||
People who have difficulty breathing due to pneumonia may require extra [[oxygen]]. An extremely sick individual may require [[artificial ventilation]] and [[intensive care medicine|intensive care]] as life-saving measures while his or her immune system fights off the infectious cause with the help of antibiotics and other drugs. | People who have difficulty breathing due to pneumonia may require extra [[oxygen]]. An extremely sick individual may require [[artificial ventilation]] and [[intensive care medicine|intensive care]] as life-saving measures while his or her immune system fights off the infectious cause with the help of antibiotics and other drugs. | ||
Revision as of 17:50, 19 August 2015
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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Philip Marcus, M.D., M.P.H.[2]
Overview
Antimicrobial therapy is the mainstay of treatment for bacterial pneumonia. Patients with severe disease, comorbidities, and/or complications usually require hospitalization and multidrug therapy.
Medical Therapy
Antimicrobialss are the treatment of choice for bacterial pneumonia. The choice of antibiotic depends on the nature of the pneumonia, the microorganisms most commonly causing pneumonia in the geographical region, and the immune status and underlying health of the individual. In the United Kingdom, Amoxicillin is used as first-line therapy in the vast majority of patients who acquire pneumonia in the community, sometimes with added Clarithromycin. In North America, where the "atypical" forms of community-acquired pneumonia are becoming more common, Clarithromycin, Azithromycin, or fluoroquinolones as single therapy, have displaced Amoxicillin as first-line therapy. Local patterns of antibiotic-resistance should always be considered when initiating pharmacotherapy. In hospitalized individuals or those with immune deficiencies, local guidelines determine the selection of antibiotics. These antibiotics are typically given intravenously.
Treatment of gram-positive organisms
- Streptococcus pneumoniae - Amoxicillin (or Erythromycin in patients allergic to penicillin); Cefuroxime and Erythromycin in severe cases.
- Staphylococcus aureus - Flucloxacillin (to counteract the organism's β-lactamase)
Treatment of gram-negative organisms
- Haemophilus influenzae
- Klebsiella pneumoniae
- Escherichia coli
- Pseudomonas aeruginosa
- Moraxella catarrhalis
Treatment of atypical organisms
Most atypical causes of pneumonia require treatment for 14-21 days.
- Chlamydophila pneumoniae - Doxycycline
- Chlamydophila psittaci - Erythromycin
- Mycoplasma pneumoniae - Erythromycin
- Coxiella burnetti - Erythromycin
- Legionella pneumophila- Erythromycin, with Rifampicin sometimes added.
People who have difficulty breathing due to pneumonia may require extra oxygen. An extremely sick individual may require artificial ventilation and intensive care as life-saving measures while his or her immune system fights off the infectious cause with the help of antibiotics and other drugs.