Treatment and prevention of legionellosis
Last reviewed: 23.04.2024
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Etiotropic treatment of legionellosis is carried out with erythromycin in a daily dose of 2-4 g daily for 2-3 weeks or other drugs from the group of macrolides (clarithromycin, azithromycin, spiromycin). In severe cases, erythromycin is administered as a phosphate or ascorbate intravenously drip 0.6-1 g / day (max. 2-3 g) or combine parenteral and oral administration of erythromycin 500 mg four times a day. Such intensive treatment of legionellosis is especially indicated in patients with legionellosis developing against the background of immunodeficiency, pulmonary-cardiac insufficiency. Perhaps a combination of drugs from the group of macrolides with rifampicin. Rifampicin is prescribed in a dose of 0.15-0.3 g three times a day. Fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin) are highly effective. The duration of treatment with antibiotics is 2-3 weeks. Pathogenetic treatment of legionellosis involves oxygen therapy, almost every fourth patient needs IVL. It is advisable to include in the complex therapy of leukinferon. The drug is administered in / m to 10 000 ME 1-3 times a day for 5-7 days.
Anti-shock measures, fighting with bleeding and intoxication are carried out by conventional methods. The question of the use of glucocorticoids in legionellosis therapy remains controversial. If legionellosis is complicated by acute renal failure, hemodialysis is performed.
Terms of incapacity for work
Determine on the basis of the features of the course of the disease in an individual patient. Radiographic changes in the lungs can persist up to 2-3 months, signs of renal failure - up to 3-9 months. Asthenovegetative syndrome - during the year.
Clinical examination
Clinical examination of patients involves consultations of a pulmonologist, a neurologist. The determining criterion for the duration of dispensary observation is the patient's well-being and the normalization of clinical indicators, laboratory and instrumental research data.
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How to prevent legionellosis?
Since there is no reliable data on the contagiousness of the infection and the possibility of transferring it from person to person, it is considered inexpedient to carry out quarantine measures. Specific prevention of legionellosis is not carried out. It is particularly important to detect the water reservoir of the pathogen in a timely manner, the ways of formation of the water aerosol and disinfect (disinfecting the bathrooms, formal nets with chlorine-containing preparations, disinfecting and replacing conditioners, etc.). At industrial plants, power stations, hospitals and hotels, closed water systems must be cleaned and disinfected at least twice a year. Chlorination and heat treatment are replaced by a wide application of disinfectants that do not contain chlorine (devices for ultraviolet irradiation, devices that enrich the water with ions of silver and copper).