Sunday, December 4, 2022

What Antibiotics Are Used For Pneumonia

Types Of Antibiotics For Pneumonia

Pneumonia Treatment, Nursing Interventions, Antibiotics Medication | NCLEX Respiratory Part 2

Pneumonia is a respiratory infection that affects the lower part of the respiratory system, primarily the lungs or the bronchi.

The bronchi are the air passages that connect the lungs to the windpipe.

Because pneumonia causes the air sacs in your lungs fill with pus and fluid, pneumonia can make it harder to take in oxygen and expel carbon dioxide.

Pneumonia is typically caused by a virus or bacterial infection.

Sometimes fungal infections can lead to pneumonia, but that is rarer, and typically occurs in people with weak immune systems due to other diseases.

Viral pneumonia will often resolve on its own, though it still frequently requires medical care for supportive treatment.

Sometimes pneumonia occurs during or after another viral illness, like the flu or a cold.

If your pneumonia is caused by a virus, antibiotics wont help unless there is also a secondary bacterial infection.

If you have bacterial pneumonia, you will need antibiotics to prevent complications and to help your body clear the infection.

Even with antibiotics, it can still take 4-6 weeks to recover from bacterial pneumonia.

Most bacterial pneumonia that is community-acquired comes from the bacteriaStreptococcus pneumoniae.

There are several different antibiotics are effective at treating this bacterial infection.

Which Oral Antibiotics Are Recommended On Completion Of Intravenous Therapy

The selection of agents for oral administration following initial intravenous therapy is based on antimicrobial spectrum, efficacy, safety and cost considerations. Although it may appear logical to select the oral formulation of a parenteral agent, this is not essential and such oral agents may not meet the criteria for selection. For macrolides, oral clarithromycin is better tolerated than oral erythromycin. A clinical judgement can be made whether to change to oral monotherapy in those who have responded favourably to parenteral combination therapy or where there is microbiological documentation of the nature of the infection, in which case the recommendations in should be adopted.

Recommendations

  • The antibiotic choices for the switch from intravenous to oral are straightforward where there are effective and equivalent oral and parenteral formulations.

  • In the case of parenteral cephalosporins, the oral switch to co-amoxiclav 625 mg three times daily is recommended rather than to oral cephalosporins.

  • For those treated with benzylpenicillin + levofloxacin, oral levofloxacin with or without oral amoxicillin 500 mgâ1.0 g three times daily is recommended.

How Is Walking Pneumonia Different From Regular Pneumonia

Walking pneumonia differs from typical pneumonia in several ways, including:

  • Walking pneumonia is a milder form of pneumonia.
  • Walking pneumonia usually does not require bed rest or hospitalization.
  • Walking pneumonia is usually caused by Mycoplasma pneumoniae. Typical pneumonia is most commonly caused by Streptococcus pneumoniae or influenza virus or rhinovirus.

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Is Walking Pneumonia Contagious If So How Is It Spread And Who Is Most At Risk

Yes, walking pneumonia caused by Mycoplasma pneumoniae is contagious . When an infected person coughs or sneezes, tiny droplets containing the bacteria become airborne and can be inhaled by others who are nearby.

The infection can be easily spread in crowded or shared living spaces such as homes, schools, dormitories and nursing homes. It tends to affect younger adults and school-aged children more than older adults.

The risk of getting more severe pneumonia is even higher among those who have existing respiratory conditions such as:

The symptoms of walking pneumonia may come on slowly, beginning one to four weeks after exposure. During the later stages of the illness, symptoms may worsen, the fever may become higher, and coughing may bring up discolored phlegm .

B Empiric Therapy For Patients Who Require Inpatient Management

Amoxicillin 500mg
  • Obtain urine culture to confirm susceptibility
  • First-line empiric therapy*:
  • Ceftriaxone 1g IV Q24H +/- Ampicillin 2 g IV Q6H
  • Second-line empiric therapy* :
  • Gentamicin 7 mg/kg IV Q24HOR
  • Ciprofloxacin 500 mg PO BID
    • Step down to appropriate oral antibiotics when patient is afebrile and hemodynamically stable, based on culture and susceptibility results
    • Usual duration of therapy is 7 days for uncomplicated pyelonephritis complicated infections require 10-14 days of therapy and occasionally longer, in consultation with Urology and Infectious Diseases

    *Suggest coverage for extended-spectrum beta-lactamase producing organisms in the following circumstances:

    • Known ESBL colonization

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    What You Need To Know About Iv Antibiotics And Intravenous Therapy

    Millions of people are prescribed medications to treat a range of illnesses and ailments every day. According to the Centers For Disease Control and Prevention, nearly half of the people in the United States have used at least one prescription medication in the last 30 days. Depending on the type of medication that is prescribed, the condition that is being treated and the duration of treatment, a doctor may prescribe intravenous therapy.

    Intravenous therapy is a method of delivering medications, nutritional support and hydration into the body via an infusion. IV therapy is administered in a hospital or clinical setting where the patient is made to feel comfortable and encouraged to relax during treatment. Here is what you should know about intravenous therapy and what to expect if your doctor has prescribed or suggested it as a treatment option.

    What Antibiotics Are Used For Hospital

    Antibiotics such as piperacillin-tazobactam, cefepime, levofloxacin, imipenem, and meropenem are suggested for the treatment of suspected MSSA infections. When MSSA is identified as the pathogen, the patient should be switched to oxacillin, nafcillin, or cefazolin. If MRSA is detected, the antibiotic should be changed to daptomycin, vancomycin, or linezolid.

    When treating patients with HAP, physicians should always keep in mind that these are often polymicrobial processes that require multiple drugs to treat. In addition, since most cases of HAP occur among hospitalized patients, who often have other health problems that need to be treated too, using antibiotics carefully is important because overuse of antibiotics can lead to the development of drug-resistant bacteria, which would then be harder for doctors to treat.

    Hospital-acquired pneumonia is a common infection that affects about half of all hospitalized patients at some point. HAP is defined as an acute pulmonary disease that develops more than 48 hours after admission to the hospital. It includes both ventilator-associated pneumonia and nonventilator-associated pneumonia .

    The main risk factor for developing HAP is being admitted to the hospital.

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    What Should I Know About Storage And Disposal Of This Medication

    Your healthcare provider will tell you how to store your medication. Store your medication only as directed. Make sure you understand how to store your medication properly.

    Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDAs Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

    How Is Walking Pneumonia Treated

    Antibiotics after pneumonia: Study finds overprescribing at hospital discharge

    Walking pneumonia is usually mild, does not require hospitalization and is treated with antibiotics . Several types of antibiotics are effective. Antibiotics that are used to treat walking pneumonia caused by Mycoplasma pneumoniae include:

    • Macrolide antibiotics: Macrolide drugs are the preferred treatment for children and adults. Macrolides include azithromycin and clarithromycin . Over the past decade, some strains of Mycoplasma pneumoniae have become resistant to macrolide antibiotics, possibly due to the widespread use of azithromycin to treat various illnesses.
    • Fluoroquinolones: These drugs include ciprofloxacin and levofloxacin . Fluoroquinolones are not recommended for young children.
    • Tetracyclines: This group includes doxycycline and tetracycline. They are suitable for adults and older children.

    Often, over-the-counter medications can also be taken to help relieve symptoms of nasal congestion, cough and loosen mucus buildup in the chest. If you have a fever:

    • Drink more fluids

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    Children Between 60 Days And 18 Years Of Age

    Diagnosis. History taking and a complete physical exam are critical to diagnose CAP in children. History of the patient should include the age of the child, type of symptoms and date of onset, immunization status , possibility of aspiration, and recent exposure to tuberculosis. The complete physical exam, including vital signs, can often help determine the severity of pneumonia. Severely ill children should be evaluated for signs of parapneumonic effusion or empyema, including dyspnea, dry cough, pleuritic chest pain, frictional rub on auscultation, or diminished breath sounds. In less acutely ill children, the following combinations of clinical findings are the most predictive of severe CAP :

    • In infants less than 12 months of age: nasal flaring and oxygen saturation less than 96 percent on room air and respiratory rate above 50 and intercostal retractions.
    • In children 1 to 5 years of age: SpO2 less than 96 percent and respiratory rate above 40.
    • In children greater than 5 years of age: SpO2 less than 96 percent and respiratory rate above 30.

    In the outpatient setting, high-dose amoxicillin has been demonstrated to be a reasonable option for CAP, since Streptococcus pneumoniae is a common pathogen among children. According to the Te xas Childrens Hospital clinical guideline, outpatient treatment differs by age group:

    In an inpatient, non-ICU setting, recommended therapy according to age groups is:

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    A Look At Antibiotics To Treat Pneumonia

    This chart provides a simple way to answer questions that pharmacists will receive this winter.

    Winter is almost here, and a typical phone call to the pharmacy will likely involve questions about antibiotics to treat pneumonia.

    When doctors call, it is usually because the patient has multiple drug allergies and/or drug interactions that make antibiotic selection difficult. Based on Infectious Disease Society of America/American Thoracic Society guidelines, I have organized the information in a chart that makes sense to me.1-3 This chart is my sole creation, and I encourage others to formulate their own charts if they do not understand or like mine. I organized my chart from the least-aggressive drug regimen to the most aggressive.

    The antibiotic choices are empiric treatment only. Once a bacterium is identified in the cultures, de-escalation occurs to avoid unnecessary adverse effects, costs, and possible drug resistance.

    Normal Healthy Person

    Healthy person with asthma or other comorbidities

    Amox, plus macrolid

    Quin

    Patient sick enough to be admitted to hospital

    Ceftriaxone

    Patient sick enough for the intensive care unit

    Ceftriaxone plus azithromycin

    Pcn allergic aztreonam, plus quin

    Patient sick enough for the ICU and high risk for methicillin-resistant staphylococcus and pseudo

    Zosyn, plus vanco

    Zosyn plus vanco –high risk for aggressive pseudo add quin, aminoglycoside plus azithromycin, or quin plus amino glycocie

    References

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    A Comparative Cost Analysis Of Antibiotic Treatment For Community Acquired Pneumonia In Adult Inpatients At Piggs Peak Government Hospital In Swaziland

    • Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

    Background: Of the different types of pneumonia, community acquired pneumonia , has been identified as the leading cause of infectious morbidity and mortality in the western and developing countries. To eradicate the bacterial cause of CAP, medical doctors) often tend to prescribe a differing cocktail of medicine which may be costly for the health care system.

    Aim: To analyze the cost of oral and/or intravenous antibiotic medicine use in different treatment approaches for treating CAP in adult inpatients from the health care system perspective.

    Settings: This study was undertaken at Piggs Peak Government Hospital, a 220 bed tertiary hospital located in the rural northern Hhohho region of Swaziland.

    Method: Seventy-one medical records of adult patients, hospitalized and diagnosed with CAP at Piggs Peak Government Hospital from July 2014 to June 2015, were retrieved and entered into the database once confirmed as having met the selection criteria. Only direct antibiotic medicine costs were considered. The total cost per treatment option was calculated by multipling the unit cost of the medicine by the administration frequency and the length of hospital stay. The Kruskal-Wallis test was used to compare the cost difference between more than two treatment options.

    How Is Pneumonia Treated

    Pneumonia, Bronchiectasis, and Lung Abscess

    When you get a pneumonia diagnosis, your doctor will work with you to develop a treatment plan. Treatment for pneumonia depends on the type of pneumonia you have, how sick you are feeling, your age, and whether you have other health conditions. The goals of treatment are to cure the infection and prevent complications. It is important to follow your treatment plan carefully until you are fully recovered.

    Take any medications as prescribed by your doctor. If your pneumonia is caused by bacteria, you will be given an antibiotic. It is important to take all the antibiotic until it is gone, even though you will probably start to feel better in a couple of days. If you stop, you risk having the infection come back, and you increase the chances that the germs will be resistant to treatment in the future.

    Typical antibiotics do not work against viruses. If you have viral pneumonia, your doctor may prescribe an antiviral medication to treat it. Sometimes, though, symptom management and rest are all that is needed.

    Most people can manage their symptoms such as fever and cough at home by following these steps:

    If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids and antibiotics, as well as oxygen therapy, and possibly other breathing treatments.

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    Legionella Mycoplasma Chlamydophila Pcr

    1) Legionella PCR

    Whereas the Legionella urinary antigen test can only diagnose the L. pneumophila serogroup 1, PCR can diagnose all serogroups, and thus has higher sensitivity for Legionella diagnosis. In a recent systematic review, the sensitivity of the Legionella PCR test using respiratory organ samples was 97.4%, and its specificity was 98.6% . Legionella PCR may be performed using nasopharyngeal samples or nasal swabs when no sputum is secreted even in the induced sputum analysis, but this testing method has a lower diagnosis rate compared with when sputum samples are used .

    2) Mycoplasma PCR

    Various serological tests have been traditionally used to diagnose Mycoplasma. These tests may fail to detect antibodies in the early period after infection , and IgM antibody reactions may not occur in adults aged 40 years or older . Mycoplasma PCR, which uses various respiratory organ samples has higher sensitivity, has higher sensitivity than serological tests , and has similar sensitivity to that of Legionella PCR . Just as Legionella PCR, Mycoplasma PCR has a lower diagnosis rate with nasopharyngeal samples than with sputum samples .

    3) Chlamydophila PCR

    What Treatment Will My Child Need

    Your child will be given antibiotics to treat their pneumonia if doctors suspect its caused by bacteria. Its not always easy to tell if pneumonia is caused by bacteria or a virus. Sometimes doctors may decide to give antibiotics if they cant be sure of the cause.

    If its likely that your child has bacterial pneumonia, they will be given antibiotics in liquid or tablet form to fight the bacteria. Your childs symptoms will usually improve within the first 48 hours – but theyll probably continue to cough for longer.

    Its important to finish the whole course of antibiotics, even if your child seems better. If they dont finish the whole course, the bacteria may not have been treated fully. This means that bacteria can become resistant to the antibiotics, making it harder to treat the pneumonia.

    If your childs pneumonia is caused by a virus then antibiotics wont work. Usually, symptom management and rest are all that are needed for treating viral pneumonia.

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    What Are The Different Generations

    Cephalosporins are grouped together based on the type of bacteria that theyre most effective against. These groups are referred to as generations. There are five generations of cephalosporins.

    To understand the differences between the generations, its important to understand the difference between Gram-positive and Gram-negative bacteria.

    One of the main distinctions between the two is their cell wall structure:

    • Gram-positive bacteria have thicker membranes that are easier to penetrate. Think of their cell wall as a chunky, loose-knit sweater.
    • Gram-negative bacteria have thinner membranes that are harder to penetrate, making them more resistant to some antibiotics. Think of their wall as a piece of fine chain mail.

    Current Who Guidelines And Rationale

    Antibiotics for pneumonia part 1

    The Revised WHO Classification and Treatment of Pneumonia in Children at Health Facilities: Evidence Summaries was published in 2014 . The revision integrated input from two consultations which used the GRADE approach : the 2010 WHO Recommendations on the Management of Diarrhoea and Pneumonia in HIV-infected Infants and Children: Integrated Management of Childhood Illness and the 2012 Recommendations for Management of Common Childhood Conditions, Evidence for Technical Update of Pocket Book Recommendations. The revisions include updating the classification of pneumonia severity and changing the recommendation for first-line antibiotics .

    The 2014 guidance reclassified CAP requiring treatment at a healthcare facility into three categories: very severe pneumonia, severe pneumonia and non-severe pneumonia. The new approach was designed to simplify the management of pneumonia at the outpatient level, reduce the number of referrals for hospitalisation and achieve better treatment outcomes.

    Very severe pneumonia is defined as cough or difficulty breathing plus any of the following: central cyanosis inability to breastfeed, drink, or vomiting everything convulsions, lethargy, or unconsciousness and severe respiratory distress. Severe pneumonia is defined as cough or difficulty breathing and one of the following: lower chest-wall indrawing nasal flaring grunting with no signs of very severe pneumonia, especially if < 2 months of age.

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    Evaluation Of Predictors For Bacterial Co

    Compared to white cell counts and procalcitonin level, the C-reactive protein level had the best diagnostic accuracy for documented infections, with an AUC of 0.822 and 95%CI 0.756â0.887 in the overall cohort of patients and an AUC of 0.720 and 95%CI 0.633â0.808 for patients diagnosed with COVID-19 pneumonia. However, the sensitivity and specificity for C-reactive protein were below 90% for both groups of patients. The diagnostic accuracy of procalcitonin levels at a cut-off of > 0.11 ng/mL was poor with AUC of less than 0.700, while sensitivity and specificity were less than 60% and 83%, respectively .

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