Do You Treat Pneumonia With Antibiotics

How Do You Determine If Someone Has Pneumonia

Pneumonia is diagnosed with a chest X- ray. For hospital patients with pneumonia, a blood culture is also performed to see if the infection has spread from the lungs into the blood stream.

People who fail to improve or get worse during their hospitalization, despite treatment with antibiotics, may require further testing with a bronchoscopy. A bronchoscopy involves having a thin, flexible tube with a camera at the end passed through the nose or mouth into the lung. It allows us to visualize the inside of the trachea, bronchi and the lungs, collect fluid samples or take a biopsy .

Is There A Vaccine For Pneumonia

There isnt a vaccine for all types of pneumonia, but 2 vaccines are available. These help prevent pneumonia caused by pneumococcal bacteria. The first is recommended for all children younger than 5 years of age. The second is recommended for anyone age 2 or older who is at increased risk for pneumonia. Getting the pneumonia vaccine is especially important if you:

• Are 65 years of age or older.
• Smoke.
• Have certain chronic conditions, such as asthma, lung disease, diabetes, heart disease, sickle cell disease, or cirrhosis.
• Have a weakened immune system because of HIV/AIDS, kidney failure, a damaged or removed spleen, a recent organ transplant, or receiving chemotherapy.
• Have cochlear implants .

The pneumococcal vaccines cant prevent all cases of pneumonia. But they can make it less likely that people who are at risk will experience the severe, and possibly life-threatening, complications of pneumonia.

Case Study : Graduation Day

A 16-year-old male presented with shortness of breath. Symptoms initiated with a fever 1 week prior, progressing to a cough , headache, weakness, and fatigue.

On physical exam, his breathing was harder and faster than usual. His lungs had consistent crackles, both inspiratory and expiratory, throughout his lungs, sparing only his lower-left lung. His oxygen saturation was 80%, improving to 92% with deep breaths.

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What Antibiotics Treat Pneumonia In Cats

• How long does it take for a cat to recover from pneumonia?

What Antibiotics Treat Pneumonia In Cats? In cases where it truly is difficult to know whether aspiration or bronchopneumonia is more likely, airway sampling either in the form of ETW or BAL would be recommended. The most commonly prescribed antibiotics for pneumonia include amoxicillin/clavulanate, doxycycline, and fluoroquinolones.

Compounding the situation is the fact that many of these cats may be unvaccinated or under-vaccinated, which also means they have little to no protection against many of the agents causing respiratory infections in cats. Remember, antibiotics do NOT treat viral infections whatsoever, so for simple, routine upper respiratory infections in cats, they are not indicated. We consider upper respiratory infections in cats to be very contagious, and it is not uncommon for a normal-looking kitten to be adopted from a shelter, only to start sneezing within a few days, followed shortly by all of the other cats in the house. If you are bringing home a new cat that may be infected, there are a few things you can do to try to slow the spread of upper respiratory infections to the other cats in your home.

When Should You See A Doctor

If you have asthma or chronic obstructive pulmonary disease you should ask your doctor for advice. They may have given you recommendations about increasing your inhaler medication or taking a ‘rescue pack’ of antibiotics and steroid tablets at the first sign of an infection. If not, speak with them for advice if you develop symptoms of a chest infection.

There are a number of symptoms that mean you should see a GP even if you do not have any other lung problems. They include:

• If a fever, wheezing or headache becomes worse or severe.
• If you develop fast breathing, shortness of breath, or chest pains.
• If you cough up blood or if your phlegm becomes dark or rusty-coloured.
• If you become drowsy or confused.
• If a cough lasts for longer than 3-4 weeks.
• If you have repeated bouts of acute bronchitis.
• If any other symptom develops that you are concerned about.

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Can I Prevent Pneumonia

The routine vaccinations that most people receive as kids help prevent certain types of pneumonia and other infections. If you have a chronic illness, such as sickle cell disease, you may have received extra vaccinations and disease-preventing antibiotics to help prevent pneumonia and other infections caused by bacteria.

People should get a pneumococcal vaccination if they have diseases that affect their immune system , are 65 years or older, or are in other high-risk groups. Depending on the bugs that are likely to affect them, these people also may get antibiotics to prevent pneumonia, as well as antiviral medicine to prevent or lessen the effects of viral pneumonia.

Doctors recommend that everyone 6 months and older get an annual flu shot. That’s because someone with the flu could then come down with pneumonia. Call your doctor’s office or check your local health department to see when these vaccines are available.

Because pneumonia is often caused by germs, a good way to prevent it is to keep your distance from anyone you know who has pneumonia or other respiratory infections. Use separate drinking glasses and eating utensils wash your hands often with warm, soapy water and avoid touching used tissues and paper towels.

You also can stay strong and help avoid some of the illnesses that might lead to pneumonia by eating as healthily as possible, getting a minimum of 8 to 10 hours of sleep a night, and not smoking.

Be Aware Of Your General Health

• Since pneumonia often follows respiratory infections, be aware of any symptoms that linger more than a few days.
• Good health habitsa healthy diet, rest, regular exercise, etc.help you from getting sick from viruses and respiratory illnesses. They also help promote fast recovery when you do get a cold, the flu or other respiratory illness.

If you have children, talk to their doctor about:

• Hib vaccine, which prevents pneumonia in children from Haemophilus influenza type b
• A drug called Synagis , which is given to some children younger than 24 months to prevent pneumonia caused by respiratory syncytial virus .

If you have cancer or HIV, talk to your doctor about additional ways to prevent pneumonia and other infections.

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What Increases Your Risk

You are more likely to get pneumonia if you:

• Smoke. Cigarette smoking is a strong risk factor for pneumonia in healthy young people.
• Have another medical condition, especially lung diseases such as chronic obstructive pulmonary disease or asthma.
• Are younger than 1 year of age or older than 65.
• Have an impaired immune system.
• Take medicine called a proton pump inhibitor that reduces the amount of stomach acid.footnote 3, footnote 4
• Drink excessive amounts of alcohol.
• Recently had a cold or the flu.

You are more likely to have complications of pneumonia and need to go to the hospital if you:

• Are older than 65.
• Have some other illness , or have gone to the hospital for a medical problem within the last 3 months.
• Have had your spleen removed or do not have a working spleen .
• Have an alcohol use problem.
• Have a weak immune system.
• Reside in a place where people live close together, such as a university dorm or nursing home.

Medical History And Physical Exam

Your doctor will ask about your signs and symptoms and when they began. Your doctor will also ask whether you have any risk factors for pneumonia. Your doctor also may ask about:

• Exposure to sick people at home, school, or work or in a hospital
• Flu or pneumonia vaccinations
• Exposure to birds and other animals
• Smoking

During your physical exam, your doctor will check your temperature and listen to your lungs with a stethoscope.

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Complications Caused By Pneumonia

Pneumonia can sometimes have complications. They include:

• pleurisy where the pleura, the thin linings between your lungs and ribcage, become inflamed, leading to chest pain. If you have pleurisy, you are more likely to develop fluid on the lungs.
• fluid on the lungs – about 1 in 10 people with pneumonia develop fluid around the lung, called a pleural effusion which can become infected. This may require a sample of the fluid to be taken by inserting a needle between the ribs under local anaesthetic, and if infected is likely to need a longer course of antibiotics. Occasionally, a tube is inserted into the lung to remove fluid as well.
• a lung abscess a rare complication thats mostly seen in people with a serious pre-existing illness or history of alcohol misuse.
• blood poisoning, also called septicaemia – this is where infection spreads from the lungs to the blood stream. This can cause low blood pressure and a severe illness that might need intensive care treatment.
• respiratory failure this is where pneumonia causes low levels of oxygen in the blood even in people given oxygen. This might also require intensive care treatment.

The vast majority of people recover from pneumonia and return to good health. However, pneumonia can be very serious and some people with severe pneumonia dont survive, despite the best available care. Those who are elderly or have other health problems are most at risk of severe or fatal pneumonia.

How Can Walking Pneumonia Be Prevented

Unfortunately, no vaccines are available to prevent walking pneumonia caused by Mycoplasma pneumoniae. Even if you have recovered from walking pneumonia, you will not become immune, so it is possible to become infected again in the future.

Tips for preventing walking pneumonia include:

• Cover your nose and mouth with a tissue when you sneeze or cough. If a tissue isnt available, sneeze or cough into the inside of your elbow or sleeve. Never sneeze or cough into your hands. Place used tissues into a waste basket.
• Wash your hands often with warm water and soap for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
• Wear a mask around sick people if you have respiratory conditions or other chronic health conditions that would make getting pneumonia even riskier for you.
• Get your annual Influenza shot. Bacterial pneumonia can develop after a case of the flu.
• Ask your doctor about the pneumococcal vaccine. Two types of vaccines are available, Prevnar 13® and Pneumovax 23®. Each vaccine is recommended for people at different age points or who are at increased risk for pneumococcal disease, including pneumonia.

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What Is The Outlook For Pneumonia

If you are well enough to be looked after at home, your outlook is very good. Less than 1 person in 100 will die as a result of pneumonia. Those who die tend to be people who are older, or those who also have other health problems.

If you need to be looked after in hospital, the outlook is not quite so good. 5-10 people in 100 admitted with pneumonia to an ordinary ward rather than an intensive care unit may die. Again, these will usually be people who were unwell before they had pneumonia, or the elderly. For people who need to have a tube put into their windpipe to help them breathe, the death rate rises to 1 in 4.

If the pneumonia is very severe, or caused by an aggressive type of germ , such as legionella, you may need to be moved to an intensive care unit in the hospital. In these cases the outlook is much worse. Unfortunately, as many as half of these people may die.

If you are normally well but then develop repeated bouts of pneumonia, it may be the first sign of a problem of your lung or immune system. Some tests of your immune system may be advised if pneumonia happens again for no apparent reason.

Can Gram Stains Guide Antibiotics For Pneumonia In Critical Care

Louise Gagnon

Similar outcomes in patients with ventilator-associated pneumonia suggest that antibiotics selected by Gram staining were noninferior to those based on guidelines and also significantly decreased the use of broad-spectrum antibiotics in this patient population.

The findings were Friday, April 8, in JAMA Network Open. The multicenter, open-label, noninferiority, randomized trial, Gram Stain-Guided Antibiotics Choice for VAP , was conducted for 2 years in intensive care units of a dozen tertiary referral hospitals in Japan, from April 1, 2018, through May 31, 2020.

The authors note in their paper that the 2016 clinical practice guidelines for VAP published by the Infectious Diseases Society of America and the American Thoracic Society recommend antibiotic agents active against both methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa as an empirical treatment. Adherence to these guidelines may lead to overuse of broad-spectrum antibiotic agents and could be associated with the accelerated emergence of antimicrobial-resistant organisms, the authors postulate.

The study sought to answer the question: Can Gram staining be used as an alternative to established guidelines to direct antibiotic use thereby curbing the use of broad-spectrum antibiotics without compromising patient safety and clinical outcomes?

Establishing antibiotic treatment from the results of Gram-stain collection may not be sufficiently comprehensive, Galvan said.

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Diagnostic Tests And Procedures

If your doctor thinks you have pneumonia, he or she may do one or more of the following tests.

• Chest X-ray to look for inflammation in your lungs. A chest X-ray is often used to diagnose pneumonia.
• Blood tests, such as a complete blood count to see whether your immune system is fighting an infection.
• Pulse oximetry to measure how much oxygen is in your blood. Pneumonia can keep your lungs from moving enough oxygen into your blood. To measure the levels, a small sensor called a pulse oximeter is attached to your finger or ear.

If you are in the hospital, have serious symptoms, are older, or have other health problems, your doctor may do other tests to diagnose pneumonia.

Case Study : A Return To Her Roots

A 56-year-old female, with a predisposition to frequent upper respiratory infections , returned to the office with pneumonia that was unresolved after 3 courses of antibiotics. The patients rib cage was very sore from coughing. She had been coughing up yellow and green mucus, and cried in my office from exhaustion.

Physical exam revealed inspiratory and expiratory crackles throughout her lower lungs, but her upper lungs were clear. Each course of antibiotics would help for awhile but then stop the pulmonologist told her that the infection was resistant to all the antibiotics they had tried, but that they would keep trying new ones. She reported that her boyfriend was worried about her, was very supportive, and would be willing to help her with mustard packs.

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What Is Walking Pneumonia

Walking pneumonia is a mild form of pneumonia . This non-medical term has become a popular description because you may feel well enough to be walking around, carrying out your daily tasks and not even realize you have pneumonia.

Most of the time, walking pneumonia is caused by an atypical bacteria called Mycoplasma pneumoniae, which can live and grow in the nose, throat, windpipe and lungs . It can be treated with antibiotics.

Scientists call walking pneumonia caused by mycoplasma atypical because of the unique features of the bacteria itself. Several factors that make it atypical include:

• Milder symptoms
• Natural resistance to medicines that would normally treat bacterial infections
• Often mistaken for a virus because they lack the typical cell structure of other bacteria

Can Pneumonia Be Prevented Or Avoided

There are many factors that can raise your risk for developing pneumonia. These include:

People who have any of the following conditions are also at increased risk:

• chronic obstructive pulmonary disease
• asthma
• sickle cell disease

You can help prevent pneumonia by doing the following:

• Get the flu vaccine each year. People can develop bacterial pneumonia after a case of the flu. You can reduce this risk by getting the yearly flu shot.
• Get the pneumococcal vaccine. This helps prevent pneumonia caused by pneumococcal bacteria.
• Practice good hygiene. Wash your hands frequently with soap and water or an alcohol-based hand sanitizer.
• Dont smoke. Smoking damages your lungs and makes it harder for your body to defend itself from germs and disease. If you smoke, talk to your family doctor about quitting as soon as possible.
• Practice a healthy lifestyle. Eat a balanced diet full of fruits and vegetables. Exercise regularly. Get plenty of sleep. These things help your immune system stay strong.
• Avoid sick people. Being around people who are sick increases your risk of catching what they have.

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What To Expect At Home

You will still have symptoms of pneumonia after you leave the hospital.

• Your cough will slowly get better over 7 to 14 days.
• Sleeping and eating may take up to a week to return to normal.
• Your energy level may take 2 weeks or more to return to normal.

You will need to take time off work. For a while, you might not be able to do other things that you are used to doing.

Can You Treat Pneumonia At Home Without Antibiotics

In theory, it is possible to treat pneumonia at home without antibiotics if your pneumonia is not caused by bacteria.

Antibiotics kill bacteria, but they dont kill viruses. Viruses are technically not even living organisms they are just molecules that can infect other living cells and use them to multiply. In theory, you dont need antibiotics if you have viral pneumonia.

However, treating viral pneumonia without antibiotics is rarely done in practice. It is very difficult to diagnose viral pneumonia and to be 100% certain that it is all caused by a virus without any involvement of bacteria. Even when you test for and detect the flu virus and diagnose pneumonia from the flu, you can still have bacterial pneumonia on top of that. If you are sick enough from a viral pneumonia to seek medical attention, you usually get antibiotics to go take at home. If you have the flu and possible bacterial pneumonia on top of that, you go home with both antibiotics and anti-viral medication.

Sometimes you may have viral pneumonia and may not even know about it. Mild viral pneumonias may go undetected. Those people simply go to work or stay home and dont require any specific treatment at home.

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