How is pneumococcal disease treated?

Indications for hospitalization

Patients with pneumococcal infection are hospitalized only according to clinical indications. Patients with suspicion of primary bacterial meningitis, pneumonia complicated by secondary meningitis, sepsis, endocarditis are sent to the infectious hospital. Patients with sinusitis, otitis media, complicated by meningitis need emergency surgery, therefore they are hospitalized in the ENT department.

Medication for pneumococcal infection

Antimicrobial treatment of pneumococcal infection depends on the clinical form of pneumococcal infection and the severity of the patient's condition.

When meningitis before the diagnosis is clarified, the treatment is carried out according to the scheme of empirical therapy of bacterial meningitis, after confirmation of the diagnosis - according to the scheme of treatment of pneumococcal meningitis.

The detoxification treatment of pneumococcal infection is carried out according to general principles. When meningitis apply osmotic and loop diuretics, dexamethasone 0.15 mg four times a day, according to indications - anticonvulsants, nootropic drugs, antioxidants.

Schemes of etiotropic therapy for pneumococcal meningitis

Strain of pneumococcus	A drug	Daily dose	Multiplicity of administration per day	The route of administration
Penicillin-sensitive	Benzylpe-nitsillin (the drug of choice)	300-400 thousand units / kg	6th	Intramuscularly
		400-500 thousand units / kg	8	Intravenously
	Cefotaxime (an alternative drug)	200 mg / kg	4	Intravenously
	Ceftriaxone (an alternative drug)	100 mg / kg (not more than 4 g)	1	Intravenously
With intermediate resistance to penicillin	Cefotaxime (the drug of choice)	200 mg / kg	4	Intravenously
	Ceftriaxone (the drug of choice)	100 mg / kg (not more than 4 g)	1	Intravenously
	Vancomycin (an alternative drug) vancomycin	3 g, children 40 mg / kg 5-20 mg	2 1	Intravenously Intravenously Endolumbular
	Meropenem (an alternative drug)	3 g, children 40 mg / kg	3 3	Intravenously Intravenously
Resistant to penicillin	Vancomycin (the drug of choice) + vancomycin	3 g, children 40 mg / kg 5-20 mg	3 1	Intravenously Intravenously Endolumbular
	Ceftriaxone (the drug of choice)	4 g, children 100 mg kg	1	Intravenously
	Cefotaxime (the drug of choice)	12 g, children 200 mg / kg	4	Intravenously
	Vancomycin	5-20 mg	1	Endolumbalno
	Meropenem (an alternative drug)	Zg, children 40 mg / kg	3	Intravenously Intravenously
	Linezolid (an alternative drug)	12 grams	2	Intravenously

Diet

The regimen is determined by the clinical condition of the patient. A special diet is not required.

[1], [2], [3], [4], [5], [6], [7],

Approximate terms of incapacity for work

The period of incapacity for work is determined taking into account the clinical form of pneumococcal infection and the severity of the disease course. When meningitis, the average duration of incapacity for work is 2 months, while maintaining residual phenomena, a disability group is established.

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Clinical examination

The neurologist spends a prophylactic medical examination for at least 1 year.

Patients who have transferred generalized forms of pneumococcal infection are advised to examine the immune status, avoid hypothermia, prevent flu and ARVI, and, on the recommendation of the physician, tempering procedures.

Treatment of pneumococcal infection should be combined with the following recommendations: after transferred meningitis, insolation, eating foods with a high salt content (herring, pickles), abundant drink, alcoholic beverages are contraindicated.

[10], [11], [12], [13], [14], [15],