Antibiotics pneumonia

Posted on by admin

What antibiotics are used for pneumonia

Modern medicine does not stand still and new effective drugs are being created to treat various diseases, including pneumonia. But despite this, every year the number of patients suffering from this dangerous disease only increases, and cases of death are not uncommon.

Table of contents:

This is facilitated by poor ecology, smoke, harmful working conditions, decreased immunity, constant mutation of dangerous pathogens and the emergence of new ones.

What is pneumonia

Pneumonia is inflammation of the lungs. It occurs due to infection in the body and is very difficult. Its symptoms are:

  • Dyspnea.
  • General weakness.
  • Intoxication of the body, accompanied by vomiting.
  • High body temperature (above 38 degrees), which lasts for several days.
  • Cough with phlegm or blood.
  • Headache.

To correctly make a diagnosis, it is necessary to donate blood, sputum for laboratory tests, and take a chest x-ray. If the diagnosis is correct, the doctor prescribes antibiotic treatment. For pneumonia, this is the surest treatment. Antibiotics for pneumonia help eliminate the source of inflammation.

The use of antimicrobial drugs is necessary to prevent the development of pathogens, bacteria, rods, viruses and to minimize the risk of complications. If you do not start treatment in a timely manner, you may waste time. Because of this, subsequent treatment can take a very long time, and in some cases, delay can be fatal.

Types of antibiotics to treat pneumonia

Only a doctor prescribes antibiotics for pneumonia, based on the signs of a certain type of pneumonia (lobar, atypical, hilar, focal, aspiration).

Broad-spectrum antibiotics used for pneumonia are of the following types:

  • Penicillin series (penicillin, amoxicillin, augmentin, oxacillin, ampicillin).
  • Cephalosporins (cephilim, cefexime, ceftobilprole, cephalexin, ceftriaxone).
  • Macrolides (erythromycin, clarithromycin).
  • Aminoglycosides (kanamycin, azithromycin, gentamicin).
  • Tetracyclines (doxycycline, minoccycline, tetracycline).
  • Fluoroquinols (levofloxacin, ciprofloxacin).

If the source of infection is identified, the doctor prescribes a drug to which the identified microorganism is sensitive. This is determined by analyzing the collected sputum from which the growth of microorganisms was obtained, thus determining sensitivity to certain antibacterial drugs.

Sometimes some antibiotics are replaced by others. This happens in the following cases:

  • If there is no improvement within 72 hours after taking antibacterial drugs.
  • Life-threatening side effects have occurred from taking a particular drug.
  • Some types of antibiotics may be too toxic for certain groups of people, such as pregnant women and children. In this case, the duration of taking the drugs is reduced or replaced with another one.

How different types of antibiotics work

Each type of antibiotic fights a specific type of pneumonia pathogen.

  • If pathogens of pneumococci are detected, penicillin antibiotics fight them very effectively. If resistance or hypersensitivity to this type of drug occurs, cephalosporins or macrolides can be used.
  • If pneumonia was caused by chlamydia or mycoplasma, treatment is carried out with macrolides, fluoroquinols, and tetracycline antibiotics.
  • Cephalosporins fight E. coli, and macrolides in combination with fluoroquinols fight Legionella.

Methods of using antibiotics

For treatment of pneumonia with antibiotics to be successful, they must be used correctly. Antibacterial drugs are administered to adults in different ways: orally, intramuscularly, inhalation, intravenously.

For the treatment of pneumonia, antibiotics are administered to infants parenterally, bypassing the digestive system, otherwise the microflora of the stomach and intestines may have a detrimental effect. Antibacterial drugs are administered by injection or inhalation. The most important thing is that children under 6 months are treated in a hospital under 24-hour medical supervision.

For adults, different antibiotics for pneumonia are administered in different ways:

  • If the disease is very severe, penicillin antibiotics are administered intravenously in the first two days, then intramuscularly. In this case, the transition from one form of drug administration to another is called a “stepped” course of treatment.
  • Due to their low toxicity, cephalosporins can be administered intravenously and intramuscularly. They often replace penicillin if the patient is hypersensitive to this antibiotic.
  • Macrolides do an excellent job against staphylococci, corynebacteria, streptococci and pneumococci. This drug continues to act even after its withdrawal, having sufficiently accumulated in the lung tissues.
  • In the hospital, if the causative agent of pneumonia has not been identified, aminoglycosides and fluoroquinyls are used, both individually and in combination with each other. The effect will be the same.

If pneumonia occurs in mild or moderate form without complications, the correctly chosen antibacterial drug helps to completely recover from this disease in 10 days. Pneumonia caused by mycoplasma, legionella or chlamydia is treated for about a month until complete recovery.

When antibiotics don't help with pneumonia

This happens for several reasons:
  • Resistance of microorganisms to the antibiotic chosen for the treatment of pneumonia.
  • With a constant change of antibiotics, due to which microorganisms adapt to them and become resistant.
  • When trying to cure pneumonia yourself, choosing an antibacterial drug yourself. Because of this, microorganisms also adapt to various types of the drug, which no longer help.
  • If the dosage of the antibacterial drug was chosen incorrectly. This happens with self-treatment.

Principles of therapy

To treat pneumonia, you must take antibiotics for at least seven days. After this, a control X-ray of the chest is taken to exclude the presence of a source of infection in the lungs. If it is detected, the course of treatment is repeated, but with a different antibacterial drug. In some cases, a consultation with a phthisiatrician is possible.

Pneumonia must be treated in a hospital. Independently and often incorrectly selected antibiotics in many cases cause side effects, the patient’s condition can worsen, the risk of complications increases and the prognosis for treating pneumonia worsens.

  • Author: Irina Vasilievna Komarova
  • Print
  1. 5
  2. 4
  3. 3
  4. 2
  5. 1

Answers questions

Ⓒ 2017 All rights reserved

Copying site materials is possible without prior approval if you install an active indexed link to our site.

Source: http://stoma.guru/preparaty/kakie-antibiotiki-ispolzuyut-pri-pnevmonii.html

Antibiotics for pneumonia. Treatment of pneumonia with antibiotics in adults and children

Pneumonia is a disease that occurs in both adults and very young children. The causative agents are viruses, bacteria, and other microorganisms. The main danger that can be expected from this disease is an extremely difficult physical condition and even death. That is why therapy must be timely. Pneumonia is mainly treated with antibiotics.

How does pneumonia develop? Classification

Most often, this disease occurs due to pathogenic microflora entering the respiratory tract: staphylococci, pneumococci, legionella, E. coli and others. In this case, inflammatory processes develop in the tissues of the respiratory organs. Also, pneumonia can be triggered by viral infections and certain toxic substances; rarely, pneumonia is a consequence of chest injury. There is a risk group that includes smokers, people who abuse alcohol, patients who have been on bed rest for a long time, as well as the elderly. Depending on the type of pathogen, bacterial, viral, fungal and mixed pneumonia are distinguished. If one lung is affected, then they speak of unilateral inflammation. There may also be bilateral, total, lobar, segmental pneumonia. Depending on epidemiological data, the disease can be nosocomial, community-acquired, atypical, or caused by an immunodeficiency state.

Main symptoms of the disease

One of the main symptoms of the development of inflammatory processes in the lungs is coughing. Also, when breathing, you may feel characteristic pain and shortness of breath. Pain is especially acute when taking deep breaths or coughing. Pneumonia causes a high body temperature. However, pneumonia is not always accompanied by an increase. The patient feels weakness throughout the body, fatigue, decreased appetite, possible nausea and even vomiting. Symptoms are especially severe in older people and children. All this suggests that to alleviate the condition and avoid the development of complications, it is necessary to start taking antibiotics for pneumonia. This disease has a peculiarity: antibacterial drugs are prescribed immediately, without waiting for laboratory tests. After receiving the results of the sputum analysis, treatment is adjusted.

Stages of the disease

Experts distinguish three degrees of severity of respiratory inflammation. The mild stage is characterized by mild intoxication, the body temperature is within 38 ºС, the heartbeat is not accelerated. At the same time, the person maintains a clear consciousness. X-ray examination reveals a small affected area. With a more severe degree, the temperature may increase to 39 ºС, and intoxication is more pronounced. Moderate tachycardia is observed, shortness of breath appears. Infiltration is clearly visible on x-rays. The most severe degree is characterized not only by high temperature (up to 40 ºС), but also by clouding of mind. A person may become delirious, and shortness of breath occurs even in a calm state. At the same time, the intoxication of the body is pronounced.

Antibiotic for pneumonia in adults

This group of drugs is aimed at destroying pathogenic flora. First of all, the specialist must suppress the acute symptoms of the disease. In this case, antibiotics are prescribed that have a wide spectrum of action.

The doctor then sends the sputum sample to the laboratory. The research results obtained influence further treatment. The specific pathogen that provoked the disease is determined. The specialist selects the necessary antibiotic for pneumonia in adults, the action of which will be aimed at destroying this microorganism. A combination of drugs is often required, since there may be several pathogens. For proper selection of medications, an antibiogram is used.

Antibioticogram

This test helps determine whether the patient's body is sensitive to a specific antibiotic. After all, the market is saturated with all kinds of drugs, and often bacteria show resistance to one type of drug, but are destroyed by another. The patient's sputum is required for the study. The sample is exposed to different drugs. During this analysis, the most effective antibiotics for pneumonia are selected for a particular patient. They will inhibit the growth of microorganisms. Weaker drugs will not interfere with their development. The accuracy of such research is high. The only drawback is that you need to wait a long time for the results: they will be ready after 2-5 days.

Groups of antibiotics used in the treatment of pneumonia

Most often, treatment of pneumonia with antibiotics begins with broad-spectrum drugs. These include penicillins, macrolides, tetracyclines, fluoroquinols, aminoglycosides, and cephalosporins.

Penicillins are one of the first antibacterial drugs. They are natural and semi-synthetic. Penetrates well into body fluids and tissues. They can also cause a number of undesirable effects: diarrhea, hypersensitivity, allergic reactions. Treatment of pneumonia with antibiotics of this type is effective if the causative agents are streptococci and staphylococci.

Tetracyclines are drugs that are used less and less. The reason for this is the resistance of microorganisms to their action. Another peculiarity of the drugs is their ability to accumulate in bone tissue. However, they can lead to tooth decay. Therefore, such antibiotics for pneumonia are not prescribed to pregnant women, women during breastfeeding, young children, or patients who have kidney problems. Representatives of drugs of the tetracycline group are “Doxycycline”, “Tetracycline”.

Cephalosporin group

There are 4 generations of this type of medicine. First generation drugs include Cefazolin, Cephalexin, etc. They actively act on bacteria from the cocci group (pneumococci, staphylococci). The second generation of drugs has good antibacterial properties against both gram-positive and gram-negative flora. The half-life is approximately 1 hour. Cephalosporins, which belong to the third generation, have an excellent effect on microorganisms that are resistant to drugs of the penicillin group (Cefotaxime, Cefoperazone). They are used to treat severe forms of infections. Cefepime is the name of fourth generation antibiotics for pneumonia. They are the most active. Among the adverse reactions after taking cephalosporins, allergies are most often identified. About 10% of patients report allergic reactions to these drugs.

Macrolides. Aminoglycosides

Macrolides are used to neutralize cocci, legionella, and chlamydia. They are well absorbed into the body, but food intake somewhat slows down this process. Allergic reactions are very rare. Representatives of this category are drugs such as Erythromycin, Azithromycin, Clarithromycin. Their main area of ​​application is infectious processes in the respiratory tract. However, liver dysfunction is a contraindication to taking such medications.

Aminoglycosides are antibiotics for pneumonia that actively act on aerobic gram-negative microorganisms. They are also used in cases where the disease is caused by more than one type of bacteria, and therefore it is necessary to combine antibacterial drugs to achieve the desired result. Representatives of the group are drugs such as Gentamicin and Amikacin. The dosage is calculated depending on the patient’s body weight, age, and severity of the disease. When taking such drugs, control of glomerular filtration in the kidneys is necessary.

Class of quinols and fluoroquinols

Medicines in this category are divided into 4 generations. Non-fluorinated (this is the first generation) actively affects legionella and E. coli. They have a somewhat less effect on chlamydia and cocci. First generation drugs are used for mild infections. The remaining quinols (second to fourth generation) are fluorinated. All medications are well distributed in the body. They are excreted from the body primarily by the kidneys. The main contraindications for use are the period of pregnancy and hypersensitivity to the drug. In addition, the use of non-fluoridated drugs is undesirable for patients who have problems with the liver or kidneys. Fluoroquinols are not prescribed to children (under 18 years of age). The only exception may be the absence of an alternative option. This class includes drugs such as Ciprofloxacin, Pefloxacin, Levofloxacin. These medications are administered intravenously only by drip.

What are the rules for prescribing antibacterial drugs?

If pneumonia is diagnosed, only a specialist decides which antibiotics to take. After you start using medications, you can replace them with others. The indications for this are serious side effects that may occur during treatment with certain drugs. Also, a replacement occurs if the doctor does not observe the desired result (and changes for the better should appear on the second or third day). Some antibiotics are quite toxic. Therefore, their reception cannot last long. In general, treatment of pneumonia in adults with antibiotics lasts 10 days. But more serious infections require a much longer period of time (about a month). The specialist must take into account the general condition of the patient, the presence of certain concomitant and chronic diseases, and the person’s age. When prescribing antibacterial drugs, it is also important to be able to create a dose of the drug in the blood that will be sufficient for the given severity of the disease.

In what forms are antibiotics used?

Depending on the stage of the disease and the severity of its course, various methods of administering drugs are used. Mostly in the first days of illness, medications are administered by injection. Cephalosporin (antibiotics for pneumonia) injections are given intravenously or intramuscularly. This is possible due to their low toxicity. The peculiarity of macrolides is that they accumulate and continue to act even when the medication is stopped. Mild forms of the disease are treated within 10 days. In this case, antibiotics for pneumonia in tablets can be used. However, experts say that the oral form of medication is not as effective. This is because it is difficult to calculate the exact dosage. It is not recommended to frequently change medications, as this may develop resistance of microorganisms to antibiotics.

Features of the treatment of pneumonia in children

Pneumonia is especially dangerous for young patients. The disease can occur even in children. The main symptoms of pneumonia in young patients are wheezing, coughing, difficulty and rapid breathing, and high fever (which lasts for quite a long time). It is worth paying attention to the baby’s behavior. He loses his appetite, becomes lethargic and restless. The most important symptom of pneumonia in young children is a blue discoloration of the area between the lips and nose. As a rule, pneumonia occurs as a complication after acute respiratory viral infections, and not as an independent disease. There are also congenital pneumonias (the causative agent is the herpes virus, mycoplasma), infection can occur directly during or after childbirth. In newborns, the airways are small and gas exchange is less intense. Therefore, the disease is more severe.

Antibiotics and children

As for adults, the mainstay of treatment for pneumonia in children is antibiotics. For pneumonia in children, they are administered parenterally. This makes it possible to minimize the impact of drugs on the microflora of the digestive system. It is also possible to take medications by injection or inhalation. The last method is the most comfortable for young children. If the child’s age does not exceed 6 months, then treatment is carried out exclusively in a hospital, where the baby is under the constant supervision of specialists. The course of therapy for children is 7 days when taking drugs of the penicillin group, cephalosporins. If the doctor prescribed macrolides (this could be Azithromycin, Clarithromycin), then the duration of treatment is reduced to 5 days. Antibiotics for pneumonia in children should show effectiveness within 3 days. Otherwise, the drug may be replaced.

Under no circumstances should you self-medicate. Even the best antibiotics for pneumonia, which helped one child, may be ineffective or even dangerous for another. It is very important to strictly adhere to your medication schedule. You should not take synthetic vitamins and other immunomodulatory drugs at the same time. To prevent the occurrence of pneumonia, you should avoid hypothermia and promptly treat colds and other infectious diseases. Don't forget about proper balanced nutrition.

Source: http://www.syl.ru/article/179647/new_antibiotiki-pri-pnevmonii-lechenie-pnevmonii-antibiotikami-u-vzroslyih-i-detey

JMedic.ru

Pneumonia is one of the most dangerous infectious diseases of the respiratory tract (airways), which is characterized by damage to the lower respiratory tract (alveoli) and lung parenchyma. The main principle of its treatment (as with bronchitis) is antibiotic therapy - that is, treatment aimed at eliminating the pathogen (that is, defeating the microorganism that led to pneumonia).

Without the use of antibiotics for pneumonia, it is almost impossible to cure a patient, since the rare immune system can cope with pneumonia on its own. All other approaches and techniques (treatment with probiotics, expectorants, detoxification therapy, antipyretic drugs, and everything else) are purely auxiliary, as with bronchitis. It is important to understand that using only antibiotic therapy, pneumonia can be cured, although with side effects that are very unpleasant, not without it. Without an antibiotic, pneumonia is incurable, unlike bronchitis, and there is a high probability of death, especially in a child.

It is not for nothing that before Fleming invented penicillin, pneumonia was one of the most common causes of death. It is fair to say that the invention of antibiotics is a new word in medicine, bringing it to a qualitatively new level. No homeopathic or Ayurvedic medicine can compare with the effectiveness of antibiotics, despite all the promotion that some pharmaceutical companies do.

So, into what groups are antibiotics classified for pneumonia and bronchitis, which of them are used in the treatment of pneumonia? This question is ambiguous, since, by and large, representatives of absolutely all pharmacological groups are applicable in the treatment of pneumonia. However, in the absolute, overwhelming majority of cases, the following groups of antibiotics for pneumonia are used:

Broad-spectrum beta-lactam group

These include penicillins, cephalosporins and carbapenems. The most proven representatives of these subgroups are as follows:

  • Broad-spectrum cephalosporins. There are four generations of broad-spectrum cephalosporins.
  • Penicillins (unprotected and protected forms, which are characterized by resistance to the action of beta-lactamases - enzymes secreted for the purpose of protection by bacteria) - ospamox, augmentin, amoxiclav, sulbactam, ampicillin.
  1. First group. The most famous representative is cefazolin.
  2. The second group is zinacef, cefuroxime.
  3. The third group, the most popular, the best are ceftriaxone, cefoperazone, cefodox, cefix, cephalexin (the name of the oral form).
  4. The fourth group is cefepime. Prescribing this antibiotic for pneumonia is advisable for hospital-acquired pneumonia; it only treats this group of diseases.
  • Broad-spectrum carbapenems – meronem, imipenem.

Macrolide group

Broad-spectrum antibiotics for pneumonia and bronchitis, produced exclusively in oral form. Well-proven antibiotics for pneumonia, long known in the domestic and foreign pharmaceutical markets. It should be noted that for some time there has been an increase in the resistance of microorganisms to these antibiotics due to incorrect diagnosis and non-compliance with the gradation of therapy, however, today the most modern forms of macrolides work well. The most famous and effective representatives today are azithromycin (Ziomycin, Sumamed, Azitsin-Darnitsa, Ormax, Azitro-Sandoz), clarithromycin (Klacid), rovamycin (Roxilide).

Fluoroquinolones

This is a group of broad-spectrum antibiotics for pneumonia and bronchitis, which has its own niche of use. It is used mainly as a reserve drug, in the presence of contraindications to all other groups. The most commonly used subgroup is the third generation respiratory fluoroquinolones, the best known representative is levofloxacin (Tigeron, Eleflox); Fourth generation fluoroquinolones, Ozerlik, are also used. Ciprofloxacin has proven itself to be the drug of choice in the treatment of all kinds of intestinal infections, although it can also help effectively cope and cure pneumonia.

A group of antibiotics for pneumonia and bronchitis - Aminoglycosides. They are considered reserve drugs. As a rule, amikacin or gentamicin is used against pneumonia. Incredibly effective drugs, but cause severe side effects.

Glycopeptides

A group of antibiotics for pneumonia and bronchitis - Glycopeptides. Vancomycin is a powerful antibiotic, used against pneumonia only in the intensive care unit.

In which clinical case is it better to prescribe which antibiotic?

There are several specific rules according to which antibiotics are prescribed for pneumonia, bronchitis and other infectious diseases:

  1. The principle of gradation. That is, when prescribing an antibiotic (with the exception of allergic reactions or particularly severe clinical cases), it is worth going from the simpler to the stronger. This is all explained by the fact that after a stronger antibiotic is prescribed (for example, ceftriaxone), ospamox will no longer work, microorganisms will be resistant to it (the so-called strength of the antibiotic is indicated in the list above, in ascending order). At least that's what the classical school teaches.
  2. The principle of strict adherence to the required course. That is, the course of antibiotic treatment (standard) is at least seven days (macrolides are used, as a rule, from three to five days). There is an improvement in the general condition, the temperature drops, in most cases already on the second or third day from the start of antibiotic therapy, and many patients stop treatment at this point. This is very in vain, since in this case resistance (resistance) develops in microorganisms, and this antibiotic will no longer be more effective; a stronger drug will have to be prescribed. In addition, the whole situation is complicated by the fact that strains of antibiotic-resistant bacteria are formed that infect other people - thus, many antibiotics have already lost their effectiveness.
  3. The principle of consanguinity. If an allergy to a particular drug occurs, all antibiotics of this group are contraindicated (that is, if an allergy to ceftriaxone is detected, all beta-lactams - amoxiclav, tienam, and cefepime - cannot be used).
  4. The principle of empirical therapy. Broad-spectrum antibiotics are prescribed, since during the initial therapy of the patient, cultures are not yet ready to determine the pathogen and its sensitivity to various antibacterial drugs. Replacement is made only if the inoculated microorganism is determined to be resistant to the selected broad-spectrum antibiotic. In most cases, tests of this kind have only retrospective significance and do not provide treatment.

Patient management tactics in each individual case

These are all the general rules and algorithms for treating pneumonia and bronchitis with antibiotics (and, in fact, like all other infectious diseases). However, in practice it is often necessary to deviate from these generally accepted standards and choose other antibiotics for pneumonia, especially if you have to treat it at home.

First, let's look at outpatient (polyclinic) practice. A patient comes to the consultation with complaints of an increase in temperature to febrile levels, a severe cough with the release of a large amount of sputum. Auscultation reveals an abundance of moist rales in the lower parts of the lungs; percussion - dullness of sound over one of the areas. Plus – classic symptoms in the form of intoxication, catarrhal manifestations. Yes, this patient does not yet have a plain X-ray of the chest organs, no, and for the next week there will be no sputum culture to determine the sensitivity of microorganisms to antibiotics; even a general analysis of urine and blood is not ready. However, he needs to start empirical therapy with broad-spectrum antibacterial drugs right now. Even if suddenly the diagnosis of pneumonia is not confirmed and there is ordinary bronchitis, you will still need to use an antibiotic. So the tactics of conducting will not change.

Which antibiotic is best for pneumonia? Good question. We must start solely from what characteristics the patient has and where we will treat him. An important note: only a mild form of pneumonia in the most responsible adult patient can be treated on an outpatient basis, that is, at home. All other cases should be sent to the hospital.

In the case of treatment at home, it would be best to use Augmentin 1000 mg at the rate of one tablet three times a day, with an interval of eight hours, for a course of seven days. If the patient has the opportunity to do intramuscular injections at home, it is better to prescribe ceftriaxone intramuscularly, one gram twice a day with an interval of twelve hours (again, a slight deviation from the standards of treatment, but in this case it is justified, since Augmentin loses its effectiveness with each during the day). If an atypical etiology is suspected, you can prescribe a macrolide - azithromycin or clarithromycin, one tablet once a day, for a course of three to five days, depending on the severity of the condition. It is also possible to prescribe fluoroquinolones (for example, if the patient is allergic to beta-lactams) - then it will be possible to take levofloxacin 500 mg against pneumonia, drink one tablet once a day, a course of five days, regardless of , at home or in the hospital.

In the case of inpatient treatment of pneumonia or bronchitis, it is immediately necessary to use injectable forms of antibiotics for pneumonia in adults. If there is ordinary, community-acquired pneumonia, you can completely get by with antibiotics for pneumonia in adults, such as ceftriaxone, zinacef or cefoperazone. If there is a suspicion of a hospital infection (the same Pseudomonas aeruginosa), cefepime is recommended.

And if methicillin-resistant staphylococcus (MRSA) is cultured, it is necessary to use the most powerful antibiotics - aminoglycosides, carbapenems or glycopeptides. Today, the most powerful antibiotic therapy regimen is the combination of tienam + vancomycin + amikacin - it covers all microorganisms currently known to science.

Regarding the use of antibiotics in children, the difference lies in the dosages and the fact that many groups of antibacterial drugs are not applicable in childhood. Fighting pneumonia at home is also too risky. In children, only penicillins, cephalosporins and macrolides can be used. All other groups - exclusively for health reasons and in cases where the expected benefit outweighs the possible risk.

conclusions

Antibiotic therapy is a serious direction in therapy, and therefore it is still better not to treat pneumonia at home. If only because you will have to give injections intravenously, intramuscularly - and this can cause an infection.

Source: http://jmedic.ru/pnevmoniya/antibiotiki_pri_pnevmonii.html

Antibiotics for pneumonia

Pneumonia is a serious infectious disease that affects the lungs. Despite effective medications, almost 10% of all patients die from pneumonia. The people who suffer the most are the elderly, those with weakened immune systems, and children.

Pathogens of pneumonia

With pneumonia, the causative agent of the disease enters the lungs, the inflammatory process begins in the alveoli, spreading to other parts. Then exudate appears (liquid released by small blood vessels during inflammation), respiratory failure occurs, and over time it can develop into cardiac failure.

Infectious pneumonia can be caused by:

  1. Bacterial infection, among its pathogens are identified:
    • Pneumococci and staphylococci;
    • Gram-negative microorganisms, Haemophilus influenzae and Escherichia coli, Legionella;
    • Viral infections - herpes, adenoviruses;
    • Mushrooms.
  2. A non-communicable disease can occur:
    • As an allergic reaction;
    • Poisoning with highly toxic substances;
    • Due to injury in the chest area;

Atypical pneumonia is another type of pneumonia. It occurs due to the influence of organisms that are similar in nature to both viruses and bacteria.

All types of pneumonia have a number of the same symptoms and there is a possibility of incorrect diagnosis, which is why the treatment may be prescribed incorrectly. Symptoms with inadequate treatment will increase - the cough will intensify, the general condition will worsen, and even death is possible.

As a rule, the patient is hospitalized and immediately prescribed a course of therapy - vitamins, increased nutrition, antipyretics, but the main treatment is the use of antibiotics.

An antibiotic is a substance that inhibits the growth of living cells; it is not used to treat influenza, hepatitis, measles, since it has no effect on viruses. The antibiotic appeared in 1928, when the American scientist Alexander Fleming, while conducting an experiment, accidentally discovered a mold that produced a substance that kills bacteria - he called it “penicillin.” In the USSR, penicillin was improved by the Soviet microbiologist Zinaida Ermolyeva; its effectiveness was one and a half times higher than its imported counterpart.

Purpose and treatment regimen

A regimen has been developed for the treatment of pneumonia: at the initial stage, antibiotics are prescribed - intravenously or intramuscularly. A sufficient concentration of the drug is needed to more effectively combat the disease, then switch to oral treatment.

  1. While there is no laboratory report on the causative agent of the disease, broad-spectrum drugs are prescribed, based on certain signs suggesting the cause of the disease - sputum, temperature.
  2. An analysis is carried out to determine bacteria. As a rule, this takes at least 3 days.
  3. If necessary, treatment is adjusted depending on the results of the study.

For mild to moderate pneumonia, it can be treated orally - with tablets or syrups (for children).

The result of the treatment is noticeable after 4 days. If no effect of treatment is observed, other antibiotics are prescribed.

This could be one of the following:

amoxicillin, clavulanate, ampicillin, benzylpenicillin, cefotaxime, ceftriakone, as well as levofloxacin or moxifloxacin - intravenously or intramuscularly

After 4 days, if a positive effect is achieved, clinical symptoms disappear (temperature normalizes, cough and other symptoms decrease) and the patient switches to oral use of the same medications.

Treatment of severe pneumonia in adults

In severe cases of pneumonia, a stay in intensive care is required, as serious consequences are possible:

  • acute respiratory failure
  • hypotension with
  • pleurisy;
  • lung abscess;
  • sepsis;
  • infectious-toxic shock and other serious consequences.

To prevent the development of complications, a combination of drugs is used. Also the basis for using combinations are:

  1. Severe form of pneumonia.
  2. Reduced immunity.
  3. There are several causative agents of infection, which makes the use of one drug ineffective.
  4. The emergence of immunity to the drug.

Therefore, intensive treatment is immediately prescribed, introducing a combination of drugs intravenously:

  • clarithromycin, erythromycin, spiramycin with antibiotics:
  • amoxicillin or clavulanate, cepefim, cefotaxime, ceftriaxone.

Alternative drugs are levofloxacin moxifloxacin ofloxacin ciprofloxacin with cefotaxime or ceftriaxone intravenously.

In addition, the treatment is step-by-step; only a specialist can select the correct treatment regimen; it depends on the causative agent of the disease, which is determined in the laboratory by sputum and blood. This process can last more than a week, which is why broad-spectrum antibiotics are used.

The duration of taking the medicine is one day.

Repeated antibiotic treatment

If there is no improvement within 3 days, then the treatment is ineffective - the antibiotics were chosen incorrectly. A repeat analysis is performed to clarify the pathogen, then the treatment is adjusted. There are other possible reasons for which there is a need for re-treatment:

  • incorrect dosage;
  • the patient self-medicated;
  • long-term treatment with antibiotics, in which it develops to a specific drug;
  • uncontrolled use of antibiotics, frequent drug changes.

If a situation arises, some drugs are replaced by others - Ticarcillin, Piperacillin.

Antibiotics for pneumonia in children

Treatment for children is prescribed immediately when signs of the disease are detected.

  • children under 1 year of age, if intrauterine infection is confirmed;
  • children with congenital defects of the heart muscle and circulatory system;
  • children from orphanages, from families with poor social and living conditions
  • children with encephalopathy (damage to the structure and function of the brain);
  • children under five years of age if more than one lobe of the lung is affected;
  • if the child is less than two months old;
  • children with severe disease, regardless of age;
  • children under two years of age with lobar (lobar) pneumonia;
  • Children are hospitalized if parents do not follow doctors' recommendations.

The treatment regimen until accurate results are obtained is broad-spectrum antibiotics; after laboratory testing and detection of the pathogen, each child is prescribed individual treatment, taking into account the age of the little patient.

How are antibiotics prescribed for children?

For doctors, when treating children, the age of the child is important. Firstly, it depends on what pathogens caused pneumonia and, secondly, not all drugs are recommended for children.

  • In newborns, a common cause of the disease is group B streptococci and Escherichia coli listeria.
  • From 1 to 3 months - pneumococcus, Staphylococcus aureus, Haemophilus influenzae.
  • From 3 months to 5 years - pneumococci and hemophilus influenzae.
  • From the age of 5, most often pneumococci, mycoplasmas, and chlamydophila.

Due to the high drug resistance of pathogens, the following drugs are not used to treat children:

1. Penicillin, Bicillin Oxacillin, Ampicillin

2. Cephalexin Cefazolin Cefamezine

3. Norfoxacin ofloxacin.

In this regard, treatment of newborns up to 3 months is carried out with amoxicillin with clavualanic acid. From this age up to 5 years, treatment with tablets or syrup - macrolide or amoxicillin is possible.

Older children are treated according to the same scheme.

Consequences of antibiotic treatment

The use of antibiotics is necessary, including for diseases such as pneumonia. But the treatment also has side effects, which depend on the dose of the medicine taken and the duration of use. What are the most common adverse reactions:

  • disorders of the digestive tract - nausea, diarrhea, vomiting; abdominal discomfort;
  • dysbacteriosis;
  • allergic reaction - itching, rashes, in severe cases - anaphylactic shock, urticaria;
  • candidiasis (thrush);
  • anemia;
  • hepatitis and pyelonephritis.

There are other side effects of using antibiotics, especially if they have been taken for a long time, so doctors always warn:

Prevention

There are consequences after using antibiotics, of course, they do not always appear, but it is better to prevent the disease, for this there are simple preventive measures.

  1. The diet should be balanced - fruits, vegetables, meat and fish should be present in the daily diet.
  2. Take walks in clean air, preferably in a park or forest.
  3. Quit bad habits - especially smoking
  4. Do not lead a sedentary lifestyle, move more, do physical exercise.
  5. Drink at least 2 liters of water per day.

Preventive measures will protect against serious illness, but if the disease does appear, you should not risk your health and if the diagnosis is pneumonia, be sure to be treated with antibiotics.

Pulmonary edema: causes, clinic, tactics, help

Causes of phlegm accumulation in the throat

Related Posts

Pneumonia. Rehabilitation of adult patients

Pneumonia is a common infectious and inflammatory disease. The pathology affects the respiratory parts of the lungs and is fraught with life-threatening complications. According to the frequency of deaths...

Types of tuberculosis: types, symptoms, diagnosis

Tuberculosis is still one of the most common infectious diseases in the world. This disease mainly affects poor...

Add a comment Cancel reply

POPULAR POSTS

Lung cancer: causes, symptoms, treatment features

What does radiography show in pneumonia?

The best ways to treat cough using traditional medicine.

LATEST POSTS

Pneumonia. Rehabilitation of adult patients

Pneumonia is a common infectious and inflammatory disease. The pathology affects the respiratory parts of the lungs and is fraught with life-threatening complications. According to the frequency of deaths...

Source: http://pnevmoniya.com/lechenie/antibiotiki-pri-pnevmonii.html

3 assessments of antibiotic choice for pneumonia

Antibiotics for pneumonia are the basis of pathogenetic therapy. These drugs act directly on the causative agent of the disease, promote its destruction, and relieve the inflammatory process.

For pneumonia, antibiotics are used for a long time, for days. In some cases, drugs are changed during treatment, replacing them with newer ones with an expanded spectrum of action. Pneumonia cannot be treated without antibiotics! So, what antibiotics are used for pneumonia? What are the differences between some drugs and others? What is the antimicrobial regimen?

Indications for prescribing antibiotics

Treatment of pneumonia with antibiotics is carried out in all cases when the disease is caused by bacterial microflora. Medicines intended to combat bacteria do not affect viruses and fungal flora. The fight against fungal inflammation is carried out by using antimycotics - agents with antifungal activity (fluconazole). To treat pneumonia of viral origin, specialists use parenteral antiviral agents - kerecid, virulex.

It is worth noting that antibacterial therapy is prescribed not only to patients with clear clinical manifestations of the disease. In case of mild pneumonia, treatment with antibiotics is also indicated. Erased and hidden forms can be treated with tablets. Treatment is often carried out on an outpatient basis, without hospitalization. In case of lobar or severe focal processes, it is better to hospitalize the patient and start using parenteral forms of antibacterial agents.

Methods for choosing an antibacterial drug

The principles of antibacterial therapy for pneumonia have not changed since the forties of the twentieth century, when antimicrobial agents were developed. Antibiotics for pneumonia in adult patients are prescribed immediately after diagnosis. You cannot wait for the results of a microbiological examination of sputum to determine the sensitivity of bacteria to antibiotics, since during the waiting period the process can spread to healthy tissue. Patients are prescribed empirical antibacterial therapy - medications are selected by the doctor at random, based on his own experience and the microflora most often found in pneumonia.

Note: patients are not always treated with new drugs. The concept of novelty and effectiveness for antimicrobial agents is very relative. The causative agent of the disease may be insensitive to new drugs, but respond to treatment with outdated and theoretically ineffective means of combating infection. Therefore, when empirically prescribing therapy, preference is given not to new drugs, but to drugs with the widest possible spectrum of action. Most often, amoxiclav, cefotaxime, or treatment with tetracycline are prescribed as the first drug.

When conducting empirical therapy, it is important to monitor the timing of use of a particular therapeutic regimen. Antibiotics for pneumonia should lead to a weakening of the symptoms of the disease by the 5-6th day of treatment. Otherwise, the drug is considered ineffective, it is changed and the patient is prescribed a sputum test for sensitivity to antimicrobial drugs. After receiving the test results, the doctor selects injections that will definitely have an effect on the pathogen.

Antibiotic therapy for pneumonia is carried out for at least 10 days. When using an empirical regimen, the patient can simultaneously receive 2-3 types of drugs belonging to different groups. If the sensitivity of the microflora to chemotherapeutic agents has been determined, 1 drug is used. The use of polytherapy is inappropriate. If fungi or viruses are the causative agent, treatment is based on appropriate medications. It is necessary to take antibacterial drugs to prevent secondary infection.

Pharmacological groups of antibacterial agents used for pneumonia

Antibiotics for bronchitis and pneumonia can belong to almost all known groups of antimicrobial agents. However, most often patients have to take drugs included in the following list:

Drugs for the treatment of viral and fungal pneumonia are not considered antibiotics and are not discussed in the format of this text.

Beta-lactamides

Beta-lactamides are a large group of antibacterial agents, which includes penicillins, cephalosporins, monobactams, and carbopenems. A common property of all these drugs is the presence of a lactam ring in their chemical structure. Until recently, a negative feature of beta-lactamides was the rapid emergence of resistance to them in most bacterial strains.

The modern pharmacological industry has technologies for the production of beta-lactamase inhibitors - substances that can block the protective mechanisms of microflora (clavulanic acid, tazobactam, sulbactam sodium). Without antibiotics they are useless, but as part of complex preparations, beta-lactamase inhibitors significantly increase the effectiveness of the drug.

Prevention of pneumonia in adults, as well as treatment of already developed inflammatory processes, is carried out using the following drugs of the beta-lactam group:

  1. Amoxicillin is a semi-synthetic substance destroyed by beta-lactamases. For pneumonia it is used in tablets of 0.5 grams for adults and 0.25 grams for children. The frequency of administration is three times a day. Today, amoxicillin is considered ineffective, since most bacterial strains are resistant to semisynthetic penicillins.
  2. Amoxiclav is a combination of amoxicillin and clavulanic acid. A highly active drug, often used as an empirical drug of choice for bacterial lung disease in adults. For severe infections, the drug is prescribed at a dose of 1000 mg every 12 hours. Moderate and mild pneumonia allows the use of amoxiclav 625 mg every 12 hours. For a newborn patient, amoxiclav is prescribed in the form of a mixture, ¼ teaspoon three times a day.
  3. Third-generation cephalosporins (cefotaxime, ceftriaxone) and fourth (cefepime) are highly effective drugs with an extremely broad spectrum of action and resistance to beta-lactamases of many bacteria. These drugs are used to prevent pneumonia in bedridden patients and to treat primary and secondary pneumonia. Ceftriaxone for pneumonia is prescribed at a dose of 1 gram of medication every 12 hours. Cephalosporins have a fairly wide dosage range, so if necessary, the dosage can be doubled. Intramuscular and intravenous administration is allowed. Suprax was developed for enteral administration.

Note: Suprax is a 3rd generation cephalosporin. The active substance is cefexime. Indicated for infections of the respiratory tract, hearing aid, and genitourinary system. Suprax is prescribed at 400 mg/day for a week.

In addition to the above remedies, pneumonia can be cured using other beta-lactams: cefpirome, cefmetazole, tazocin, carfecillin and others. However, these drugs are less effective, so their use is limited. In case of severe pneumonia, antibiotics of popular names cannot stop the process. In such situations, reserve antibiotics are used, which are included in the category of beta-lactamides and the subcategory of carbopenems (thienam) or monobactams (aztreonam).

Aminoglycosides

Broad-spectrum agents that can influence aerobic and anaerobic flora. They are used mainly for atypical pneumonia and severe cases of its characteristic forms. They bind to the ribosomal receptors of the bacterial cell, which leads to the death of the latter. They have pronounced nephrotoxic and ototoxic effects.

  1. Gentamicin is a bacteriostatic antibiotic used parenterally. Indicated for severe pneumonia and lung abscesses. Prescribed 0.4 mg/kg body weight, twice a day, intravenously or intramuscularly. During the neonatal period it is practically not used. Can be used in the diagnosis of mycoplasma pneumonia.
  2. Amikacin - for pneumonia, 0.5 grams is prescribed twice a day. The route of administration is mainly intramuscular. It is unacceptable to administer more than one and a half grams of the drug during the day. Used for bacterial pneumonia and bronchitis.
  3. Kanamycin - administered intramuscularly, 0.5 grams every 12 hours, diluted with novocaine. Like the previous drug, kanamycin is effective for bronchitis and pneumonia. Indications for its use are extremely severe bacterial processes, bronchopneumonia.

When deciding how to treat inflammation, we should not forget that aminoglycosides are contraindicated in renal pathology and diseases of the auditory nerve.

Video

Video - antibiotics for pneumonia

Tetracyclines

They inhibit the synthesis of proteins in the bacterial cell, damaging its ribosomes. Capable of affecting large viruses, some protozoa (mycoplasma pneumonia is treated with tetracyclines), gram-positive and gram-negative bacteria. Tetracyclines are actively used for pneumonia.

  1. Tetracycline - 0.25 grams three times a day. The course of therapy is shorter than that of a drug such as the above-described amoxiclav or amoxicillin, and lasts 5 days.
  2. Doxycycline - dosage is 2-4 mg/kg, 1 time per day, for 10 days. It is recommended to use in conjunction with antifungal drugs for bronchitis, pneumonia and other infections that require high doses of antibiotics.
  3. Metacycline hydrochloride - prescribed 0.3 grams in two doses per day. Course – 10 days. Available in capsules that are easy to take.

Tetracycline is a good drug. However, people with renal and hepatic pathologies and leukopenia should avoid taking it. Also, the drug is not prescribed to pregnant women and children under 8 years of age.

Macrolides

A distinctive feature of macrolides used to treat pneumonia in adults is their cumulative effect. The drugs accumulate in the blood, maintaining therapeutic concentrations for a long time. This allows you to reduce the frequency of taking medications to 1-2 times a day. This mode is most convenient if pneumonia is being treated at home.

For inflammatory lesions of the lungs, the antibiotics of this group may be as follows:

  1. Erythromycin is one of the first macrolide drugs. To cure patients suffering from inflammatory pathology, it is prescribed 0.5 grams every 12 hours. The course of therapy is 10 days. The drug is considered outdated and ineffective. Therefore, its use is justified only in relation to uncomplicated diseases.
  2. Azithromycin is a macrolide belonging to the azalide subgroup. Azithromycin for pneumonia and bronchitis is prescribed 0.5 grams 1 time per day for the first dose, then 0.25 grams per dose as before. Therapy is carried out over a seven-day course.
  3. Oleandomycin - before treating a disease with this drug, you should make sure that the patient is not allergic to it. The drug quite often causes hypersensitivity reactions. If you have a history of allergies, oleandomycin should be replaced with amoxiclav, amoxicillin, or one of the 3rd generation cephalosporins. The drug is prescribed 0.25 grams every 6 hours for 10 days.

There are cases where even severe pneumonia was cured with macrolides. However, drugs in this category are not harmful to mycoplasmas. In addition, macrolides are not used for damage to the liver parenchyma, pregnancy, lactation, and kidney disease.

Evaluation of the effectiveness of antibacterial agents

How effective the course of therapy was prescribed by the attending physician can be judged within 72 hours from the start of treatment. In this case, the patient should have no symptoms of obvious intoxication, body temperature should not go beyond subfebrile levels, and the respiratory rate should be kept within once per minute. Elevated numbers of respiratory rate and temperature indicate low effectiveness of the prescribed treatment.

If, during the monitoring of the condition, it was revealed that the drug injected into a patient diagnosed with “inflammation of the upper respiratory tract” or “pneumonia” with bronchitis does not have the expected effect, the pharmacological therapy is changed or a respiratory fluoroquinolone (ciprofloxacin, which does not have a toxic effect) is added to the drug already used. action and rarely causes allergies). The optimal choice of injections allows you to quickly improve the patient's condition.

Note: the antibiotic therapy used is not able to immediately change the existing radiographic picture. Therefore, it is unacceptable to use images to evaluate the effectiveness of treatment in the short term. X-rays are indicated on days 8-10 of treatment.

Pneumonia is a severe pathological process for which a comprehensive treatment plan is indicated. In order to destroy pathogenic flora, 3rd and 4th generation drugs are used that can act on a large number of pathogens. For example, amoxicillin, ceftriaxone, oleandomycin. It should be remembered that bacterial pneumonia cannot be treated without antibiotics. For pulmonary pathology and bronchitis, drugs of this group are required. All discussions regarding whether pneumonia can be treated using exclusively folk remedies are dangerous and can lead to serious consequences.

Source: http://pnevmonet.ru/pnevmoniya/antibiotiki-pri-pnevmonii/