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Treatment and prevention of legionellosis
Last reviewed: 08.07.2025
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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 macrolide group (clarithromycin, azithromycin, spiromycin). In severe cases, erythromycin is administered as phosphate or ascorbate intravenously by drip at 0.6-1 g / day (maximum 2-3 g) or combined parenteral and oral administration of erythromycin at a dose of 500 mg four times a day. Such intensive treatment of legionellosis is especially indicated for patients in whom legionellosis develops against the background of immunodeficiency, pulmonary heart failure. A combination of drugs from the macrolide group with rifampicin is possible. Rifampicin is prescribed at a dose of 0.15-0.3 g three times a day. Fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin) are highly effective. The duration of antibiotic treatment is 2-3 weeks. Pathogenetic treatment of legionellosis involves oxygen therapy; almost every fourth patient requires artificial ventilation. It is advisable to include leukinferon in the complex therapy. The drug is administered intramuscularly at 10,000 IU 1-3 times a day for 5-7 days.
Anti-shock measures, control of bleeding and intoxication are carried out by generally accepted methods. The question of the use of glucocorticoids in the treatment of legionellosis remains controversial. If legionellosis is complicated by acute renal failure, hemodialysis is carried out.
Periods of incapacity for work
Determined based on the characteristics of the disease in an individual patient. X-ray changes in the lungs can persist for up to 2-3 months, signs of renal failure - up to 3-9 months. Asthenovegetative syndrome - for a year.
Clinical examination
The medical examination of patients involves consultations with a pulmonologist and a neurologist. The determining criterion for the duration of the medical 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 its transmission from person to person, it is considered inappropriate to carry out quarantine measures. Specific prevention of legionellosis is not carried out. It is especially important to promptly detect the water reservoir of the pathogen, the ways of formation of water aerosol and carry out disinfection (disinfection of bathrooms, shower nets with formalin and chlorine-containing preparations, disinfection and replacement of air conditioners, etc.). In industrial enterprises, power plants, hospitals and hotels, closed water systems must be cleaned and disinfected at least twice a year. Chlorination and heat treatment are being replaced by the widespread use of chlorine-free disinfectants (devices for ultraviolet irradiation, devices enriching water with silver and copper ions).