Treatment of pneumonia in adults: principles and drugs
Pneumonia is the development of inflammatorychanges in lung tissue. This is due to the ingress of microbes (mainly bacteria, but there may be viruses and fungi) in various ways. The danger of pneumonia is that the more or less extensive area of the lung turns off from the gas exchange process, which reduces the delivery of oxygen to the tissues. In addition, the body is poisoned by products of inflammation and destruction of the pulmonary parenchyma.
- in out-of-hospital conditions (such pneumonia is called "non-hospital");
- a person undergoing treatment in a hospital for any other disease;
- arisen because of neurologic disorders (seizures, loss of consciousness), as a result of which the contents from the stomach got into the respiratory tract (aspiration pneumonia);
- in people with reduced immune defense.
Depending on which of the four species is observed in this case, and also considering age and the presence of chronic diseases, treatment of pneumonia in adults is prescribed.
How does a microbe enter the lungs?
1) On the bronchi:
- when they hit an aerosol, densely contaminated with pathogenic microbes. This is characteristic more for tuberculosis or viral pneumonia;
- by inhaling the contents of your own mouth andpharynx. This process occurs almost always during deep sleep, increases when taking a sleeping pill or under the influence of alcohol. Normally, local immune defense of the lungs works, but when it is weakened by the action of the virus, when the microbes are too much or they are very aggressive, pneumonia arises.
2) Through the blood from another focus of inflammation. For example, from a bone - at an osteomyelitis, from valves of heart - at an endocarditis.
3) By contact:
- When pus comes from an adjacent organ, for example, with liver abscess;
- with penetrating chest injury.
Principles on which pneumonia is treated in adults
If the diagnosis is "pneumonia," this isassumes the appointment of one or two antibiotics, since even if the cause was a virus (for example, the influenza virus), the bacterial flora is attached in any case.
In theory, an antibiotic should be prescribedafter the microbial pathogen of inflammation has been determined, and also its sensitivity to the preparations has been obtained. But this requires mandatory coughing up of phlegm, which can not be done by every patient, as well as a 4-5 day wait for the result, which is unacceptable. The loss of time can lead to the death of the patient. Therefore, antibiotics are prescribed empirically, preferably after the person has given a sputum to a bacteriological study, but on the same day and preferably at the same hour as the diagnosis was made (there is evidence that a loss of even 4 hours significantly worsens the prognosis).
- Type of pneumonia: non-hospital, arisen inside the hospital or another.
- The volume of lesions of the lung tissue: segmental, lobar, polysegmentary, one- or two-sided.
- The patient's condition: takes into account his general state of health, shortness of breath, blood pressure level, degree of oxygen saturation of blood.
- Age.
- Presence of concomitant pathology of the heart, lungs (eg, chronic bronchitis), kidney.
Treatment is carried out at home or in a hospital in the department of therapy or pulmonology. Sometimes hospitalization is required in the intensive care unit.
Pneumonia: Diagnosis
Therefore, the diagnostic standard is to perform a chest X-ray, and computer tomography may also be needed.
Treatment of pneumonia in adults with antibiotics
For treatment, such antibiotics are used:Amoxiclav, Cefix, Sumamed, Levofloxacin, and Avelox. They are prescribed in tablets, often their combination is used. For example, with a medium flow, such a complex of drugs can be prescribed: Sumamed plus Avelox or Leflox. If the disease is caused by Klebsiella, pneumonia treatment is suggested in the hospital. In this case, intravenous and intramuscular drugs such as Amikacin, Gentamycin together with Lefloqin or Tavanik medicines are prescribed.
