Antibiotic treatment for pneumonia

In the treatment of all forms of pneumonia requires antibiotics. A wide range of medicines of this group puts specialists before choosing a drug as effective and safe for each particular patient. Partly to solve this problem by making knowledge of the General principles of prescribing antibiotics for pneumonia, as well as information about the most common mistakes made when conducting therapy antibacterial agents.

Basic errors of prescribing antibiotics for pneumonia

Basic errors of prescribing antibiotics for pneumonia occur in most cases because of the incompetence of the practitioners of an outdated treatment regimen and not taking into account the achievements of modern medicine.

Considering the fact that aminoglycosides have no activity against pneumococcus, the causative agents of community-acquired pneumonia, their use in the treatment of pneumonia developed outside the hospital were not justified. The prevalence of S. Pneumoniae strains resistant to products containing co-trimoxazole, contrary to the popularity that she received these drugs among doctors in the treatment of community-acquired pneumonia. Adversely on the effectiveness of treatment may reflect the frequent change of antibacterial drugs, increasing the likelihood of resistance of pathogens to a number of medicines.

If the patient still had some symptoms, which are found in the result of x-ray and/or laboratory tests, some doctors mistakenly believe that antibiotic therapy should be extended to the complete disappearance of all manifestations of the disease or to modify existing treatment regimens. Also irrational is considered a scheme in which, in addition to antibiotics, nystatin is included. The clinical efficacy of the combination of these two drugs in the treatment of pneumonia in patients with candidiasis who do not suffer from diseases of the immune system, and has not been proven.

Especially antibiotics for pneumonia

Replacement of antibiotics for pneumonia is required when the clinical ineffectiveness of drugs. It is important to note that to make such a conclusion only after 48-72 hours after starting treatment. The risk of serious side effects, requiring discontinuation of the drug, or toxicity of a particular group of antibiotics, which does not allow to use such medicinesfor a long time, may also be the reason for the revision of the therapeutic scheme. The main criterion for completion of treatment of pneumonia with antibiotics is the regression of the clinical picture of community-acquired pneumonia.

Uncomplicated community acquired pneumonia requires treatment with antibiotics after the body temperature is kept within the normal range for three or four days. In most cases the course of treatment with such an approach is 7-10 days. If the symptoms of the disease or epidemiological data indicate the presence of pneumonia, the cause of which were Mycoplasma, chlamydia or Legionella, antibiotic therapy may continue for 3-4 weeks, which helps to reduce the risk of relapse. The duration of treatment with antibacterial drugs in complicated community-acquired infections depends on the individual characteristics of each patient. As mentioned above, the preservation of some manifestations of the disease cannot be considered an absolute indication for longer treatment with antibiotics or making changes to an existing treatment regimen. Usually in this case, the patient is required to undergo additional screening in order to exclude some serious diseases similar in symptoms to pneumonia.

Each group of antibiotics has a specific activity against certain pathogens of pneumonia. This aspect of the preparations are reflected in the recommendations on the use of antibiotics for pneumonia, are tailored to maximum effectiveness of medicines in the fight against pathogenic microorganisms.

Streptococcus pneumoniae. The gold standard antipneumococcal therapy in this case is benzylpenicillin and aminopenicillin. Given the pharmacokinetics of drugs, is most appropriate to apply amoxicillin (the most effective antibiotic from a sore throat), rather than ampicillin, as it is two times better absorbed from the gastrointestinal tract. Beta-lactam antibiotics of other groups in their activity do not exceed the above drugs. The choice of antibiotics for therapy penicillinresistant pneumococcal pneumonia is still open. Benzylpenicillin and aminopenicillins are considered to be efficient if agents have a moderate resistant or resistant to penicillin. Some experts believe that it is more appropriate in this case, the appointment of III generation cephalosporins (cephalosporins list of all 5generations), such as Cefotaxime or Ceftriaxone. In a more detailed study of resistance of pneumococci to penicillin was found that the ineffectiveness of beta-lactam antibiotics are not insurmountable problem.

High antipneumococcal activity typical of macrolides. Between the 14-membered and 15-membered macrolides, there is complete cross-resistance, and some strains of Streptococcus pneumoniae may be sensitive to 16-membered macrolides. For fluoroquinolones peculiar marginal activity against the pneumococcus.

The use of tetracycline antibiotics (e.g. Yunidoks Solutab) and especially of co-trimoxazole as antipneumococcal drugs is limited due to the widespread distribution of pathogens that are insensitive to these drugs.

Haemofilus influenzae. Highly active antibiotics in the treatment of pneumonia caused by Haemophilus influenzae, are aminopenicilline. Taking into account the fact that 30% of strains produce beta-lactams, broad-spectrum, Deplete the natural and semisynthetic penicillins, cephalosporins of first generation and partly cefaclor, the drugs of choice in the treatment of pneumonia caused by strains Haemofilus influenzae, can be protected aminopenicillins, such as amoxicillin/clavulanic acid and ampicillin/sulbactam. Proved the high efficiency of fluoroquinolones in the fight against Haemophilus influenzae, as resistance to the pathogen is rare. For macrolides, a characteristic antimicrobial activity clinically relevant.

Staphylococcus aureus. The drugs of choice for treating pneumonia caused by Staphylococcus aureus, are considered oxacillin, protected aminopenicillins, cephalosporins I and II generation.

Mycoplasma pneumoniae, Chlamydia pneumoniae. The drugs of choice for treatment of Mycoplasma and chlamydial pneumonia macrolides are considered the antibiotics of the tetracycline group. Some activity against these microorganisms exhibit and fluoroquinolones.

Legionella pneumophila. The drug of choice in the treatment of pneumonia caused by Legionella, is erythromycin. According to some studies, rifampicin can be successfully used in the treatment of legionellae pneumonia with macrolides. Proven high clinical efficacy of the fluoroquinolones.

Enterobacteriaceae spp. The etiological role of microorganisms in this family (E. coli and Klebsiella pneumoniae) in the development of pneumonia is controversial. The drugs of choice in the treatment of diseases inthis case are cephalosporins of the III generation.