Antibiotics for pneumonia

Antibiotics for pneumonia are the main component of the treatment process. Pneumonia begins acutely, with a rise in temperature, a strong cough with brown or yellowish sputum, chest pain when coughing and breathing.

Treatment of pneumonia requires urgent hospitalization of the patient in the therapeutic or intensive care unit (depending on the severity of the condition). Bed rest, vitamin nutrition are recommended, and it is also important to drink plenty of fluids - tea, juice, milk, mineral water.

Since inflammation of the lung tissue most often occurs due to specific microorganisms, the most reliable way to combat the pathogen is the administration of antibiotics intramuscularly and intravenously. This method of administration makes it possible to maintain a high concentration of antibiotic in the blood, which helps fight bacteria. Most often, for pneumonia, broad-spectrum antibiotics are prescribed, since it is impossible to immediately identify the pathogen, and the slightest delay can cost lives.

Basically, macrolides (azithromycin, clarithromycin, midecamycin, spiramycin) and fluoroquinolone antibiotics (moxifloxacin, levofloxacin, ciprofloxacin) are widely used to treat pneumonia. To increase the effectiveness of treatment, antibiotics are taken according to a special scheme. At the first stage, the antibiotic is administered parenterally - intramuscularly or intravenously, and then antibiotics are prescribed in tablets.

Despite the wide choice of antibiotics in pharmacies, you should not self-medicate, but rather seek help from an experienced specialist, since antibiotics are selected strictly individually, based on the analysis data for the pneumonia pathogen. In addition, pneumonia treatment is based not only on antibacterial therapy, but includes several steps in the general treatment scheme.

The most effective antibiotics for pneumonia are determined in the laboratory. To do this, a bacterial culture of sputum is done on a special medium, and depending on which bacterial colonies begin to develop, the pathogen is determined. Then a test is done for the sensitivity of the pathogen to antibiotics, and based on these results, the patient is prescribed a specific group of antibacterial drugs. But, since the process of identifying the pathogen can take up to 10 days or more, at the initial stage of pneumonia treatment, the patient is prescribed broad-spectrum antibiotics. To maintain the concentration of the drug in the blood, it is administered both intravenously and intramuscularly, combining it with anti-inflammatory, absorbable agents, vitamins, etc., for example:

• Streptococcus pneumoniae. For antipneumococcal therapy, benzylpenicillin and aminopenicillin, third-generation cephalosporin derivatives such as cefotaxime or ceftriaxone, and macrolides are prescribed.
• Haemofilus influenzae. If Haemophilus influenzae is detected, aminopenicillins or amoxicillin are prescribed.
• Staphylococcus aureus. Antibiotics effective against Staphylococcus aureus are oxacillin, protected aminopenicillins, first and second generation cephalosporins.
• Mycoplasma pneumoniae, Chlamydia pneumoniae. Antibiotics for the treatment of mycoplasma and chlamydial pneumonia are macrolides and tetracycline antibiotics, as well as fluoroquinolones.
• Legionella pneumophila. Antibiotics effective against legionella include erythromycin, rifampicin, macrolides, and fluoroquinolones.
• Enterobacteriaceae spp. Antibiotics for the treatment of pneumonia caused by Klebsiella or E. coli - third-generation cephalosporins.

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Treatment of pneumonia after antibiotics

Treatment of pneumonia after antibiotics may be due to the choice of ineffective drugs or violation of the intake of antibacterial agents - incorrect dosage, violation of the regimen. In a normal course, antibiotics are taken until the temperature is normalized and then for another 3 days. In severe cases of pneumonia, treatment can take up to 4-6 weeks. If positive dynamics of the disease is not recorded during this period, then the reason is incorrect antibacterial treatment. In this case, a repeated analysis for bacteria is carried out, after which a course of correct antibacterial therapy is carried out. After complete recovery and positive X-ray results, sanatorium and resort treatment, smoking cessation, and enhanced vitamin nutrition are indicated.

A patient may need additional antibiotic treatment after pneumonia if:

• Incorrectly selected antibiotic for treatment.
• Frequent changes of antibiotics.

Antibiotic treatment after pneumonia may also be necessary if the disease recurs. The reason for this is long-term antibiotic treatment, which suppresses the body's defenses. A similar result also occurs as a result of self-medication and uncontrolled use of antibiotics in unspecified doses.

Treatment of pneumonia after antibiotics should be carried out in a hospital, with systematic X-ray control. If after 72 hours the clinical picture does not change or if during the end of treatment the inflammation focus on the X-ray does not decrease, a repeated course of treatment is indicated, but with a different antibiotic, and a consultation with a phthisiatrician is also necessary.

Antibiotics for pneumonia in adults

Antibiotics for pneumonia in adults are prescribed depending on the patient's age and the severity of the condition. Pneumonia is most often caused by various bacteria, less often by fungi and protozoa. At the first stage of treatment, until the final results, broad-spectrum antibiotics are prescribed, and the patient is also asked whether he has previously suffered from pneumonia, tuberculosis, diabetes, chronic bronchitis, or whether he is a smoker. In addition, in elderly patients, the pathogens of the disease differ from similar cases in younger patients.

If the prescribed drug is ineffective and until the bacteriological analysis of sputum is received, it is recommended not to change the selected antibiotic for 3 days. This is the minimum time for the concentration of the antibiotic in the blood to reach its maximum and for it to begin to act on the lesion.

• For mild pneumonia in patients under 60 years of age, Avelox 400 mg per day (or Tavanic 500 mg per day) is prescribed for 5 days, along with Doxycycline (2 tablets per day on the first day, 1 tablet on the remaining days) for 10-14 days. You can take Avelox 400 mg and Amoxiclav 625 mg*2 times a day for 10-14 days.
• A patient under 60 years of age, with an aggravated underlying disease and other chronic diseases, as well as a patient over 60 years of age, is prescribed Avelox 400 mg plus Ceftriaxone 1 gram 2 times a day for at least 10 days.
• Severe 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. An option is to administer Sumamed intravenously plus Fortum intramuscularly.
• In extremely severe cases of pneumonia, when the patient is hospitalized in the intensive care unit, the following are prescribed: combinations of Sumamed and Tavanic (Lefloxacin), Fortum and Tavanic, Targocid and Meronem, Sumamed and Meronem.

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Antibiotics for pneumonia in children

Antibiotics for pneumonia in children are administered immediately after diagnosis is confirmed. Children are subject to mandatory hospitalization for therapy or, in the case of a complicated course, to intensive care if:

• The child is less than two months old, regardless of the severity and location of the inflammatory process in the lungs.
• A child under three years old, diagnosed with lobar pneumonia.
• A child under five years of age, diagnosed with damage to more than one lobe of the lung.
• Children with a history of encephalopathy.
• A child under one year old with a history of confirmed intrauterine infection.
• Children with congenital defects of the heart muscle and circulatory system.
• Children with chronic diseases of the respiratory system, cardiovascular system, kidneys, diabetes mellitus and malignant blood diseases.
• Children from families registered with social services.
• Children from orphanages, from families with insufficient social and living conditions.
• Hospitalization of children is indicated if they do not follow medical recommendations and treatment at home.
• Children with severe pneumonia.

In mild bacterial pneumonia, antibiotics from the penicillin group, both natural and synthetic, are indicated. Natural antibiotics: benzylpenicillin, phenoxymethylpenicillin, etc. Semisynthetic penicillins are usually 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 before receiving the results of bacterial analysis and identifying 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 a particular drug belongs to: ampicillin - oxacillin, ampiox, piperacillin, carbenicillin, ticarcillin, cephalosporins - claforan, cefobid, etc. In modern medicine, both synthetic and semi-synthetic, as well as natural antibiotics are used to treat pneumonia. 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 broad-spectrum antibiotics that antibacterial treatment of pneumonia is usually started.

Rules for prescribing antibiotics for pneumonia:

A broad-spectrum antibacterial drug is prescribed based on the course of the disease and the color of the expectorated sputum.

• Conduct a bacterial analysis of sputum to identify the pathogen, and conduct a test for the pathogen's sensitivity to antibiotics.
• Prescribe an antibacterial therapy regimen based on the test results. In doing so, take into account the severity of the disease, its effectiveness, the likelihood of complications and allergies, possible contraindications, the rate of absorption of the drug into the blood, and the time it is eliminated from the body. Most often, two antibacterial drugs are prescribed, for example, an antibiotic from the cephalosporin and fluoroquinolone group.

Hospital pneumonia is treated with amoxicillin, ceftazidime, and if ineffective, with ticarcillin, cefotaxime. A combination of antibiotics is also possible, especially in severe conditions, mixed infections, and weak immunity. In such cases, the following is prescribed:

• Cefuroxime and gentamicin.
• Amoxicillin and gentamicin.
• Lincomycin and amoxicillin.
• Cephalosporin and lincomycin.
• Cephalosporin and metronidazole.

For community-acquired pneumonia, azithromycin, benzylpenicillin, fluoroquinolone are prescribed, in severe conditions - cefotaxime, clarithromycin. Combinations of the listed antibiotics are possible.

You should not change the antibiotic treatment line on your own, as this can lead to the development of resistance of microorganisms to certain groups of drugs, and as a consequence, the ineffectiveness of antibacterial therapy.

Antibiotic course for pneumonia

The course of antibiotics for pneumonia is prescribed by the attending physician, based on the patient's age, the severity of the disease, the nature of the pathogen, and the body's response to antibacterial therapy.

For severe community-acquired pneumonia, the following treatment is prescribed:

1. Aminopenicillins – amoxicillin/clavulanate. For young children, they are prescribed with aminoglycosides.
2. Possible treatment options:
   • Ticarcillin antibiotics
   • Cephalosporins II–IV generations.
   • Fluoroquinolones

For aspiration bacterial pneumonia, the following antibiotics are prescribed:

1. Amoxicillin or clavulanate (Augmentin) intravenously + aminoglycoside.
2. Possible treatment regimen options, purpose:
   • Metronidazole + cephalosporins III p.
   • Metronidazole + cephalosporins III + aminoglycosides.
   • Lincosamides + cephalosporins III p-th.
   • Carbapenem + vancomycin.

For nosocomial pneumonia, the following antibiotics are prescribed:

1. In case of mild pneumonia, protected aminopenicillins (Augmentin) are prescribed.
2. Possible treatment options include the use of II-III cephalosporins.
3. In severe cases, combination treatment is required:
   • inhibitor-protected carboxypenicillins (ticarcillin/clavulanate) and aminoglycosides;
   • cephalosporins III p-th, cephalosporins IV p-th with aminoglycosides.

Treatment of pneumonia is a long and serious process, and attempts at self-medication with antibiotics can not only lead to complications, but also become the reason for the impossibility of correct antibacterial therapy due to the low sensitivity of the pathogen to the drug.

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Antibiotic treatment for pneumonia caused by Klebsiella

If Klebsiella pneumonia is detected in sputum, antibiotic treatment is the main method of pathogenic therapy. Klebsiella is a pathogenic microorganism, normally found in the human intestine, and at high concentrations and reduced immunity, it can cause lung 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, diabetes, and chronic bronchopulmonary diseases.

The clinical course of pneumonia caused by Klebsiella is similar to pneumococcal pneumonia, often the inflammation is localized in the right upper lobe of the lung, and can spread to other lobes. Cyanosis, shortness of breath, jaundice, vomiting, and diarrhea develop. Pneumonia is often complicated by abscess and empyema of the lung, the reason being that Klebsiella are the cause of tissue destruction. In community-acquired pneumonia, Klebsiella, Serratia, and Enterobacter are found in sputum.

Klebsiella, Serratia and Enterobacter have different degrees of sensitivity to antibiotics, so treatment begins with the administration of aminoglycosides and 3rd generation cephalosporins, mezlocillin, amikacin is effective against the Serratia strain.

With proper and timely treatment, pneumonia caused by Klebsiella, without complications, is completely cured in 2-3 weeks.

Treatment of severe pneumonia caused by Klebsiella includes aminoglycosides (tombramycin, gentamicin 3 to 5 mg/kg per day) or amikacin 15 mg/kg per day with cephalothin, cephapirin, 4 to 12 g per day. Treatment of severe pneumonia caused by Klebsiella includes aminoglycosides (tombramycin, gentamicin 3 to 5 mg/kg per day) or amikacin 15 mg/kg per day with cephalothin, cephapirin, 4 to 12 g per day.

Antibiotic treatment of mycoplasma pneumonia

When mycoplasma pneumonia is detected in sputum, treatment is aimed at combating a specific pathogen. Once in the body, mycoplasma penetrates the mucous membrane of the upper respiratory tract, where it secretes a special secretion, causing severe inflammation at first, and then the destruction of intercellular membranes, epithelial tissues begins, which ends in necrotic degeneration of the tissue.

In the pulmonary vesicles, mycoplasmas multiply rapidly, the alveoli enlarge, and interalveolar septa may be affected. Mycoplasma pneumonia develops slowly, the onset of the disease is similar to a cold, then the temperature rises to 39-40 degrees, and a strong cough begins. The temperature lasts for about 5 days, then drops sharply, fixing at 37-37.6 degrees and lasting for a long time. The X-ray clearly shows darkened foci, degeneration in the connective tissue septa.

The difficulty of treating mycoplasma pneumonia is that the pathogen is inside neutrophils, which makes penicillins, cephalosporins and aminoglycosides ineffective. Macrolides are prescribed first: azithromycin (sumamed), spiromycin (rovamycin), clarithromycin, taken orally 2 times a day, for no more than 2 weeks, with shorter courses a relapse is possible.

Antibiotics for congestive pneumonia

Antibiotics for congestive pneumonia are prescribed for a course of at least 2 weeks. Congestive pneumonia develops with prolonged bed rest, in elderly and weakened people, as well as a complication after complex operations. The course of congestive pneumonia is slow, asymptomatic, there is no chills, fever, cough. The patient may only be bothered by shortness of breath and weakness, drowsiness, later a cough appears.

Congestive pneumonia can be treated at home, but by following all the instructions and only under the supervision of a doctor, so most often the patient is hospitalized. If a bacterial infection is also detected in the sputum (congestive pneumonia is not always bacterial in nature), then antibiotics are prescribed - cefazolin, tsifran or protected penicillin. The course of treatment is 2-3 weeks.

In case of congestive pneumonia developing against the background of heart failure, glycosides and diuretic drug complexes are additionally prescribed, along with antibacterial, bronchodilators, expectorants. In addition, therapeutic exercise and a diet rich in vitamins are indicated. In case of aspiration pneumonia, bronchoscopy is mandatory.

In general, with timely diagnosis and antibacterial therapy, high-quality prevention and maintenance of the patient's body, complications with congestive pneumonia do not develop, and recovery occurs within 3-4 weeks.

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Antibiotic Combination for Pneumonia

A combination of antibiotics for pneumonia is introduced by a doctor into the treatment regimen under certain conditions that aggravate the clinical picture of the disease. In the clinic, the use of two or more antibiotics is not approved due to the high load on the body - the liver and kidneys of a weakened person are not able to cope with such a number of toxins. Therefore, in practice, it is more acceptable to treat pneumonia with one antibiotic, the effect of which on pathogenic flora is very high.

Antibiotic combinations for pneumonia are acceptable in the following cases:

• Severe pneumonia, with secondary pneumonia.
• Mixed infection.
• Infections with suppressed immunity (cancer, lymphogranulomatosis, use of cytostatics).
• Dangers or development of resistance to the chosen 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.

You should not self-medicate, since only a doctor can prescribe the necessary dosage of the drug, and with insufficient doses of the antibiotic, microorganisms will simply develop resistance to the drug, and with too high a dose, cirrhosis of the liver, kidney failure, dysbacteriosis, and severe anemia can develop. In addition, some antibiotics for pneumonia, when combined, simply reduce each other's effectiveness (for example, antibiotics + bacteriostatic drugs).

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Best antibiotic for pneumonia

The best antibiotic for pneumonia is the one that the bacteria are most sensitive to. For this, special laboratory tests are carried out - a bacteriological sputum culture is done to determine the pathogen and then a test for sensitivity to antibiotics is done.

The main direction in the treatment of pneumonia is antibacterial therapy. Until the causative agent of the disease is identified, broad-spectrum antibiotics are prescribed. For community-acquired pneumonia, the following are prescribed: penicillin with clavulanic acid (amoxiclav, etc.), macrolides (rulid, rovamycin, etc.), 1st generation cephalosporins (kefzon, cefazolin, tsufalexin, etc.).

For hospital pneumonia, the following are prescribed: penicillin with clavulanic acid, 3rd generation cephalosporins (claforan, cefobid, fortum, etc.), fluoroquinolones (peflacin, ciprobay, taravid, etc.), aminoglycosides (gentamicin), carbapenems (tienam).

The full range of therapy consists not only of a combination of antibiotics (2-3 types), but is also aimed at restoring bronchial drainage (administration of euphyllin, berodual), liquefying and removing sputum from the bronchi. Anti-inflammatory, resorbable drugs, vitamins and components that stimulate the immune system are also administered - fresh frozen plasma intravenously, antistaphylococcal and anti-flu immunoglobulin, interferon, etc.

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Modern antibiotics for pneumonia

Modern antibiotics for pneumonia are prescribed according to a special regimen:

• If gram-positive cocci predominate, penicillin or 1st and 2nd generation cephalosporin drugs are prescribed intravenously and intramuscularly - cefazolin, cefuroxime, cefoxine.
• If gram-negative bacteria predominate, 3rd generation cephalosporins are prescribed: cefotaxime, ceftriaxone, ceftazidime.
• In case of atypical pneumonia, macrolides are prescribed - azithromycin, midecamycin, as well as 3rd generation cephalosporins - ceftriaxone, ceftazidime, etc.
• If gram-positive cocci, methicillin-resistant staphylococci or enterococci predominate, 4th generation cephalosporins are prescribed - cefipine, carbapines - tienam, meronem, etc.
• If multiresistant gram-negative bacteria predominate, 3rd generation cephalosporins are prescribed - cefotaxime, ceftriaxone, ceftazidime, and aminoglycosides are additionally prescribed.
• If fungal infection predominates, 3rd generation cephalosporins plus fluconazole are prescribed.
• If intracellular organisms predominate - mycoplasma, legionella, etc., macrolides are prescribed - azithromycin, clarithromycin, roxithromycin, etc.
• For anaerobic infections, inhibitor-protected penicillins are prescribed - lincomycin, clindamycin, metronidazole, etc.
• For pentocystic pneumonia, cotrimoxazole and macrolides are prescribed.
• For cytomegalovirus pneumonia, ganciclovir, acyclovir, and cytotect are prescribed.