How is pneumococcal infection treated?

Indications for hospitalization

Patients with pneumococcal infection are hospitalized only for clinical indications. Patients with suspected primary bacterial meningitis, pneumonia complicated by secondary meningitis, sepsis, endocarditis are sent to the infectious diseases hospital. Patients with sinusitis, otitis complicated by meningitis require emergency surgery, so they are hospitalized in ENT departments.

Drug treatment of pneumococcal infection

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

In case of meningitis, before the diagnosis is clarified, treatment is carried out according to the scheme of empirical therapy for bacterial meningitis; after confirmation of the diagnosis, treatment is carried out according to the scheme of treatment for pneumococcal meningitis.

Detoxification treatment of pneumococcal infection is carried out according to general principles. In meningitis, osmotic and loop diuretics are used, dexamethasone 0.15 mg four times a day, according to indications - anticonvulsants, nootropic drugs, antioxidants.

Schemes of etiotropic therapy of pneumococcal meningitis

Pneumococcus strain	Preparation	Daily dose	Frequency of administration per day	Route of administration
Penicillin sensitive	Benzylpenicillin (drug of choice)	300-400 thousand units/kg	6	Intramuscularly
		400-500 thousand units/kg	8	Intravenously
	Cefotaxime (alternative drug)	200 mg/kg	4	Intravenously
	Ceftriaxone (alternative drug)	100 mg/kg (not more than 4 g)	1	Intravenously
With intermediate resistance to penicillin	Cefotaxime (drug of choice)	200 mg/kg	4	Intravenously
	Ceftriaxone (drug of choice)	100 mg/kg (not more than 4 g)	1	Intravenously
	Vancomycin (alternative drug) vancomycin	3 g, children 40 mg/kg 5-20 mg	2 1	Intravenous Intravenous Endolumbar
	Meropenem (alternative drug)	3 g, children 40 mg/kg	3 3	Intravenously Intravenously
Penicillin resistant	Vancomycin (drug of choice) + vancomycin	3 g, children 40 mg/kg 5-20 mg	3 1	Intravenous Intravenous Endolumbar
	Ceftriaxone (drug of choice)	4 g, children 100 mg kg	1	Intravenously
	Cefotaxime (drug of choice)	12 g, children 200 mg/kg	4	Intravenously
	Vancomycin	5-20 mg	1	Endolumbar
	Meropenem (alternative drug)	Zg, for children 40 mg/kg	3	Intravenously Intravenously
	Linezolid (alternative drug)	12 g	2	Intravenously

Diet

The regimen is determined by the clinical condition of the patient. No special diet is required.

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Approximate periods of incapacity for work

The period of incapacity is determined taking into account the clinical form of pneumococcal infection and the severity of the disease. In meningitis, the average duration of incapacity is 2 months; if residual symptoms persist, a disability group is established.

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Clinical examination

The medical examination is carried out by a neurologist for at least 1 year.

Patients who have suffered generalized forms of pneumococcal infection are recommended to examine their immune status, avoid hypothermia, take preventive measures against influenza and acute respiratory viral infections, and, on the recommendation of a doctor, undergo hardening procedures.

Treatment of pneumococcal infection should be combined with the following recommendations: after meningitis, sun exposure, consumption of foods with a high salt content (herring, pickles), drinking plenty of fluids, and alcoholic beverages are contraindicated.

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