What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body’s response to clarithromycin.
The extended-release tablet does not dissolve in the stomach after swallowing. It slowly releases the medication as it passes through your digestive system. You may notice the tablet coating in the stool. This is normal and does not mean that you did not get the full dose of medication.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the clarithromycin, call your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Middle East Respiratory Syndrome Coronavirus
A new cause of severe pneumonia was first reported in Saudi Arabia in September 2012. Within a year, 58 cases, including 33 deaths, were reported in Jordan, Qatar, Saudi Arabia, the United Arab Emirates , France, Germany, Italy, Tunisia, and the United Kingdom. Since 2012 there have been over 1730 cases. The World Health Organization warns this new viral illness could become a pandemic. However, person-to-person transmission has been limited to close contacts. In the United States, no cases of MERS have been reported since 2014.
Other Uses For This Medicine
Clarithromycin also is used sometimes to treat other types of infections including Lyme disease , cryptosporidiosis , cat scratch disease , Legionnaires’ disease, , and pertussis . It is also sometimes used to prevent heart infection in patients having dental or other procedures. Talk to your doctor about the possible risks of using this medication for your condition.
This medication may be prescribed for other uses ask your doctor or pharmacist for more information.
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Outpatient Vs Inpatient Treatment
Choosing between outpatient and inpatient treatment is a crucial decision because of the possible risk of death.9,15,16 This decision not only influences diagnostic testing and medication choices, it can have a psychological impact on patients and their families. On average, the estimated cost for inpatient care of patients with CAP is $7,500. Outpatient care can cost as little as $150 to $350.1719 Hospitalization of a patient should depend on patient age, comorbidities, and the severity of the presenting disease.9,20
Physicians tend to overestimate a patients risk of death14 therefore, many low-risk patients who could be safely treated as out-patients are admitted for more costly inpatient care. The Pneumonia Severity Index was developed to assist physicians in identifying patients at a higher risk of complications and who are more likely to benefit from hospitalization.9,15,16 Investigators developed a risk model based on a prospective cohort study16 of 2,287 patients with CAP in Pittsburgh, Boston, and Halifax, Nova Scotia. By using the model, the authors found that 26 to 31 percent of the hospitalized patients were good outpatient candidates, and an additional 13 to 19 percent only needed brief hospital observation. They validated this model using data17 from more than 50,000 patients with CAP in 275 U.S. and Canadian hospitals.1517,21,22
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Inpatient |
Information from reference 15.
Pneumonia In The Elderly
Elderly patients with pneumonia may not exhibit typical symptoms or physical examination findings seen in younger adults, such as pleuritic chest pain, cough, fever, and leukocytosis. Signs and symptoms more frequently seen in older adults include falls, decreased appetite, or functional impairment. A change in mental status should prompt evaluation for an infectious cause., As with any adult, risk factors for atypical or drug-resistant pathogens should guide treatment. Elderly patients with history of stroke or known dysphagia are at an increased risk for aspiration pneumonia. Residents of nursing homes or long-term care facilities are at an increased risk for methicillin-resistant Staphylococcus aureus or multidrug-resistant pathogens.
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How Is Walking Pneumonia Diagnosed
Your doctor will ask you about your symptoms, how long youve had them and if any other family members or people you regularly interact with are also ill with similar symptoms. He or she will listen to your lungs with a stethoscope to check for abnormal breath sounds. Your doctor may order chest X-rays to see if there is an infection in your lungs. Your blood or mucus might be tested to determine if your pneumonia is caused by Mycoplasma pneumoniae, another bacteria, virus or fungus.
Defining Pneumonia By Origin Of Infection
Health care providers often classify pneumonia based on where the disease is contracted. This helps predict which organisms are most likely responsible for the illness and, therefore, which treatment is most likely to be effective.
Community-Acquired Pneumonia
People with this type of pneumonia contracted the infection outside of a hospital setting. It is one of the most common infectious diseases. It often follows a viral respiratory infection, such as the flu.
One of the most common causes of bacterial CAP is Streptococcus pneumoniae. Other causes include Haemophilus influenza , Mycoplasma pneumoniae, and Chlamydia pneumoniae .
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Diagnosis And Treatment Of Community
M. NAWAL LUTFIYYA, PH.D., ERIC HENLEY, M.D., M.P.H., and LINDA F. CHANG, PHARM.D., M.P.H., B.C.P.S., University of Illinois College of Medicine at Rockford, Rockford, Illinois
STEPHANIE WESSEL REYBURN, M.D., M.P.H., Mayo School of Graduate Medical Education, Rochester, Minnesota
Am Fam Physician. 2006 Feb 1 73:442-450.
Patients with community-acquired pneumonia often present with cough, fever, chills, fatigue, dyspnea, rigors, and pleuritic chest pain. When a patient presents with suspected community-acquired pneumonia, the physician should first assess the need for hospitalization using a mortality prediction tool, such as the Pneumonia Severity Index, combined with clinical judgment. Consensus guidelines from several organizations recommend empiric therapy with macrolides, fluoroquinolones, or doxycycline. Patients who are hospitalized should be switched from parenteral antibiotics to oral antibiotics after their symptoms improve, they are afebrile, and they are able to tolerate oral medications. Clinical pathways are important tools to improve care and maximize cost-effectiveness in hospitalized patients.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Patients with suspected community-acquired pneumonia should receive chest radiography.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Patients with suspected community-acquired pneumonia should receive chest radiography.
Overview of Community-Acquired Pneumonia
Definition
Definition
How Should This Medicine Be Used
Clarithromycin comes as a tablet, an extended-release tablet, and a suspension to take by mouth. The regular tablet and liquid are usually taken with or without food every 8 to 12 hours for 7 to 14 days. The extended-release tablet is usually taken with food every 24 hours for 7 to 14 days. Your doctor may tell you to take clarithromycin for a longer time depending on your condition. Take clarithromycin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take clarithromycin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the suspension well before each use to mix the medication evenly.
Swallow the long-acting tablets whole do not split, chew, or crush them.
You should begin to feel better during the first few days of treatment with clarithromycin. If your symptoms do not improve or get worse, call your doctor.
Take clarithromycin until you finish the prescription, even if you feel better. If you stop taking clarithromycin too soon, or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
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Different Generations Of Cephalosporin Medication
Violetta Shamilova, PharmD, is a board-certified pharmacist and assistant professor at Touro College in New York.
Cephalosporins are one of the most widely prescribed classes of medications in the world. Chances are you have encountered these antibiotics even if you are unfamiliar with the name. For example, among other things, Keflex is used to treat skin infections. Additionally, Rocephin is used to treat pneumonia.
What Are Cephalosporins
Cephalosporins were first discovered in sewer water off the coast of Sardinia in 1945. By 1964, the first cephalosporin was prescribed.
Cephalosporins are structurally similar to other antibiotics. Like penicillins, cephalosporins have a beta-lactam ring attached to a dihyrdothiazole ring. Hanging off this dihyrdothiazole ring are various side chains, the composition of which makes for different cephalosporins with different pharmacology and antimicrobial activity.
Cephalosporins have three different mechanisms of action. They are:
- Binding to specific penicillin-binding proteins.
- Inhibition of cell wall synthesis.
- Activation of autolytic enzymes in the bacterial cell wall.
Cephalosporins are divided into five generations. However, different cephalosporins in the same generation are sometimes chemically unrelated and have different spectra of activity .
A generalization taught to many healthcare professionals is that with subsequent generations of cephalosporins, gram-positive coverage decreases while gram-negative coverage increases.
One to 3% of all people are allergic to cephalosporins. In reality, however, this number is probably higher because people with penicillin allergies are often not prescribed cephalosporins.
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How You Catch Pneumonia
While anyone can catch pneumonia, some people are more likely to come down with illness when coming into contact with the germs. Like many other illnesses, pneumonia is caught through contact with the bacteria or virus that creates pneumonia.
Coughing and sneezing are the most common ways these germs spread.
Its also possible to catch the illness by touching something like a counter or door handle, sharing cups and utensils, and touching your face without washing your hands first.
Disease Process Leading To Pneumonia
Pneumonia-causing agents reach the lungs through different routes:
- In most cases, a person breathes in the infectious organism, which then travels through the airways to the lungs.
- Sometimes, the normally harmless bacteria in the mouth, or on items placed in the mouth or swallowed, can enter the lungs. This usually happens if the body’s “gag reflex,” an extreme throat contraction that keeps substances out of the lungs, is not working properly.
- Infections can spread through the bloodstream from other organs to the lungs.
However, in normal situations, the airways protect the lungs from substances that can cause infection.
- The nose filters out large particles.
- If smaller particles pass through, nerves along the airway prompt a cough or sneeze. This forces many particles back out of the body.
- Tiny particles that reach the small tubes in the lungs are trapped in a thick, sticky substance called mucus. The mucus and particles are pushed up and out of the lungs by tiny hair-like cells called cilia, which beat like a drum. This action is called the “mucociliary escalator.”
- If bacteria or other infectious organisms manage to avoid the airway’s defenses, the body’s immune system attacks them. Large white blood cells called macrophages destroy the foreign particles.
The above-mentioned defense systems normally keep the lungs healthy. If these defenses are weakened or damaged, however, bacteria, viruses, fungi, and parasites can easily infect the lungs, producing pneumonia.
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How Should I Take Levaquin
Take Levaquin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Take this medicine with water, at the same time each day. Drink extra fluids to keep your kidneys working properly while taking this medicine.
You may take Levaquin tablets with or without food.
Take levofloxacin oral solution on an empty stomach, at least 1 hour before or 2 hours after a meal.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device .
Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Levaquin will not treat a viral infection such as the flu or a common cold.
Do not share Levaquin with another person.
This medicine may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you use levofloxacin.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
Amoxicillin Alone Better Choice For Pediatric Pneumonia: Study
A combination of two antibiotics is often prescribed to treat community-acquired pneumonia in children, but a JAMA Pediatrics study is now showing that using just one of the two has the same benefit to patients in most cases.
Vanderbilt University Medical Center researchers reported this week that amoxicillin alone, rather than combined with azithromycin, is just as effective and a better choice as it relates to efforts to curb antibiotic resistance.
One of the most commonly used antibiotics in pediatrics, azithromycin was prescribed to 12.2 million outpatients in 2013 and accounted for almost 20 percent of all antibiotic prescriptions for children in the U. S. ambulatory setting, according to an editorial accompanying the study.
Combination therapy with azithromycin is unnecessary in most cases of pediatric pneumonia, both because the bacteria targeted by azithromycin are less common than other causes of pneumonia, including viruses, and the effectiveness of azithromycin has not been clearly demonstrated in prior studies, said lead author Derek Williams, M.D., MPH, assistant professor of Pediatrics.
By minimizing antibiotic exposure whenever possible, we can preserve the effectiveness of currently available antibiotics.
Williams and co-authors studied 1,418 children hospitalized for radiologically confirmed community-acquired pneumonia.
Thus, the combined therapy showed no benefit over the single therapy of just amoxicillin, Williams said.
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Cost Of Antimicrobial Therapy
Economic pressures have accentuated the focus on reducing health care costs and utilizing resources while maintaining or improving quality of care.31 These pressures are exacerbated by the growing resistance of S. pneumoniae to penicillin.31,32 This pattern of resistance increases the cost of treatment because of prolonged hospitalization, relapses, and the use of more expensive antibacterial agents.3337
Aspiration Pneumonia And Anaerobic Bacteria
The mouth contains a mixture of bacteria that is normally harmless. However, if this mixture reaches the lungs, it can cause a serious condition called aspiration pneumonia. This may happen after a head injury or general anesthesia, or when a person takes drugs or alcohol. In such cases, the gag reflex does not work as well as it should, so bacteria can enter the airways. Unlike other organisms that are inhaled, some of the bacteria that cause aspiration pneumonia do not need oxygen to live. These bacteria are called anaerobic bacteria.
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When To See A Doctor
If you have been sick with what seems like a cold or the flu without improvement for 5-7 days, check in with your doctor.
This could be a sign that you have pneumonia or have developed a secondary infection.
If you have a compromised immune system, are over age 65, or have other medical problems, call your doctor sooner.
Children who have symptoms of pneumonia should be seen by their pediatrician right away, since they may not display common signs of pneumonia, even if they are very ill.
Risk Factors For Community
CAP is the most common type of pneumonia. It develops outside of the hospital. Each year 2 to 4 million people in the US develop CAP, and 600,000 are hospitalized. Older people, infants, and young children are at greatest risk for the disease.
Chronic Lung Disease
Chronic obstructive lung disease , which includes long-term bronchitis and emphysema, affects 15 million people in the US. This condition is a major risk factor for pneumonia. Long-term use of corticosteroid inhalers may increase the risk of pneumonia in people with COPD. People with other types of chronic lung diseases, such as bronchiectasis and interstitial lung diseases, are also at increased risk for getting pneumonia and more likely to have complications.
Bronchitis is the inflammation of the bronchi, the main air passages to the lungs. It generally follows a viral respiratory infection. Symptoms include coughing, shortness of breath, wheezing, and fatigue.
People With Compromised Immune Systems
People with impaired immune systems are extremely susceptible to pneumonia. It is a common problem in people with HIV and AIDS. A wide variety of organisms, including P jiroveci, Myobacterium species, Histoplasma capsulatum, Coccidioides immitis, Aspergillus species, cytomegalovirus, and Toxoplasma gondii, can cause pneumonia.
In addition to AIDS, other conditions that compromise the immune system include:
- Adult and pediatric cancers, such as leukemia and Hodgkin lymphoma
- Organ transplantation
- Children
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How Is Pneumonia Treated
When you get a pneumonia diagnosis, your doctor will work with you to develop a treatment plan. Treatment for pneumonia depends on the type of pneumonia you have, how sick you are feeling, your age, and whether you have other health conditions. The goals of treatment are to cure the infection and prevent complications. It is important to follow your treatment plan carefully until you are fully recovered.
Take any medications as prescribed by your doctor. If your pneumonia is caused by bacteria, you will be given an antibiotic. It is important to take all the antibiotic until it is gone, even though you will probably start to feel better in a couple of days. If you stop, you risk having the infection come back, and you increase the chances that the germs will be resistant to treatment in the future.
Typical antibiotics do not work against viruses. If you have viral pneumonia, your doctor may prescribe an antiviral medication to treat it. Sometimes, though, symptom management and rest are all that is needed.
Most people can manage their symptoms such as fever and cough at home by following these steps:
If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids and antibiotics, as well as oxygen therapy, and possibly other breathing treatments.