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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Information from reference 15.
Which Antibiotics Treat Pneumonia
The type of antibiotic you are prescribed will depend upon your medical history and the nature of your condition. Most patients who receive treatment for mild bacterial pneumonia will receive a commonly prescribed antibiotic such as doxycycline or amoxicillin.
You should contact your doctor if your symptoms do not start to improve after three days of antibiotic treatment. This can be a sign that you need a different antibiotic, or that the cause of your pneumonia is viral rather than bacterial.
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
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Signs And Symptoms Of Pneumonia
The most common symptoms of pneumonia include cough, fever, shaking, chills, and shortness of breath. Additional symptoms that can also be present include headache, loss of appetite, fatigue, sweating, nausea and vomiting, muscle pain, and chest pain when breathing deeply or coughing. Older adults with pneumonia may experience confusion or delirium.
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.
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Chinese Traditional Patent Medicines Used In The Observation Period
Jinhuaqinggan granules derived from Yinqiaosan and Maxingshigantang by removing some herbs and adding others. This herbal product is known for dispelling the wind, ventilating the lungs, clearing the heat and toxins . Network pharmacology research found that it had multiple effective compounds, like formononetin, stigmasterol, -quebrachol, icaritin, etc., which regulated multiple pathways, such as PTGS2, HSP90AB1, HSP90AA1, PTGS1, through binding to SARS-CoV-2 3C-like protease and ACE2, resulting in the control of COVID-19 . In another study, 123 COVID-19 patients were randomly allocated to the combined treatment group and the conventional treatment group in a ratio of 2:1. After 5days treatment, the combined treatment group showed significant improvement in fever , coughing , malaise , expectoration . Scores in the TCM syndrome scale and Hamilton depression scale were significantly lower in the combined treatment group than in the conventional group . In a retrospective study, 80 COVID-19 patients were divided into two groups, receiving Jinhuaqinggan granules and conventional treatment, respectively. It was found that the duration of positive virus detection was shorter in the Jinhuaqinggan group than in the conventional group . The virus clearance rate was higher and the time to recover as shown on chest computed tomography was shorter in the Jinhuaqinggan group than in the conventional group, respectively .
How Soon After Treatment For Pneumonia Will I Begin To Feel Better
How soon you will feel better depends on several factors, including:
- Your age
- The cause of your pneumonia
- The severity of your pneumonia
- If you have other at-risk conditions
If you are generally healthy, most symptoms of bacterial pneumonia usually begin to improve within 24 to 48 hours after starting treatment. Symptoms of viral pneumonia usually begin to improve within a few days after starting treatment. A cough can last for several weeks. Most people report being tired for about a month after contracting pneumonia.
Also Check: Signs Or Symptoms Of Pneumonia
Resources For Drug Product Information
Information about expanded access regulations, other aspects of drug development and review, and resources about the approval status of drugs and formulations can be found at:
- Electronic Orange Book: This resource can be searched for holders of approved or discontinued marketing applications, especially for drugs that may have more than one source of generic preparations.
- : This resource can be searched for approval history and labeling information for approved drugs.
- ClinicalTrials.gov: This website is maintained by the National Institutes of Health as a resource for locating information about clinical trials. Posting a trial on this website does not constitute government endorsement of the trial or the product under study.
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 Is Bacterial Pneumonia Treated
Bacterial pneumonia can be treated with antibiotics, which usually help people feel better within a few days to a week.
People who are very old, very young, have shortness of breath, or have a high fever may need to be admitted to the hospital for intravenous antibiotics. If you need to go to the hospital, your doctor may do cultures from sputum or blood tests to identify and target the exact bacteria.
People with more severe cases of bacterial pneumonia may be treated with oxygen, intravenous fluids, and breathing treatments to ease symptoms.
How Your Doctor Chooses
Your doctor will select the right antibiotic for you based on multiple factors, including:
- Your age: People 65 and older have a greater risk of serious complications from pneumonia infections.
- Your health history: A history of smoking, lung diseases, or other conditions may influence a person’s ability to fight off infections.
- The exact infection you have: Your doctor may take a sample and test it for bacteria. They can then pick an antibiotic based on your specific infection.
- Your previous experiences with antibiotics: Make sure to tell your doctor if you are allergic to any medications, had bad reactions to antibiotics in the past, or have developed an antibacterial-resistant infection.
- The antibiotic sensitivity of the bacteria: The lab will test the bacteria causing your pneumonia to determine which antibiotics it is sensitive or resistant to.
Doctors typically choose your antibiotics prescription based on what medicines they think will be most effective and cause the fewest side effects.
How Is Fungal Pneumonia Treated
If the course of the pneumonia is slow and your chest X-ray looks unusual, you may have fungal pneumonia. These conditions can be diagnosed with a blood test that shows your body is making antibodies to the fungus.
More than 10 types of fungi can cause fungal pneumonia, which is more common in people with weakened immune systems.
Several antifungal drugs serve as treatment for pneumonia and can be administered either orally or intravenously.
What About Hospital Treatment
Hospital admission may be advised if you have severe pneumonia, or if symptoms do not quickly improve after you have started antibiotic treatment. Also, you are more likely to be treated in hospital if you are already in poor health, or if an infection with a more serious infecting germ is suspected. For example, if infection with Legionella pneumophila is suspected. Even if you are in hospital, you are likely to be offered antibiotics in capsule, tablet or liquid form unless you have difficulties taking them, in which case they may be given through a vein. Your antibiotic treatment will be stopped after five days, unless you are very unwell.
Sometimes oxygen and other supportive treatments are needed if you have severe pneumonia. Those who become severely unwell may need treatment in an intensive care unit.
When you return home, even though the infection is treated, you may feel tired and unwell for some time.
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.
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.
How Long Youll Take Them
A course of antibiotics for uncomplicated pneumonia treatment is usually for five to seven days. One course will usually be enough to cure your pneumonia. In some cases, you may need more than one course of antibiotics if your infection doesnt start improving or it seems like its not responding to the medications.
Stay in touch with your doctor to ensure your infection is clearing up. Youll likely start to feel better and have some symptom relief one to three days after you start your pneumonia treatment, but it may take a week or more for your symptoms to go away completely.
Taking your medication as prescribed, especially for antibiotics, is incredibly important. Even if youre feeling better, you need to take the entire course.
Do not stop taking antibiotics early, even if your symptoms improve, as the infection would not be fully treated and could become antibiotic-resistant. This will make treatment more complicated. If youre experiencing side effects, talk to your doctor. Only stop your medication if your doctor tells you its OK to do so.
Are Vaccines Available To Prevent Pneumonia
Yes, there are two types of vaccines specifically approved to prevent pneumonia caused by pneumococcal bacteria. Similar to a flu shot, these vaccines wont protect against all types of pneumonia, but if you do come down with pneumonia, its less likely to be as severe or potentially life-threatening especially for people who are at increased risk for pneumonia.
- Bacterial pneumonia: Two pneumonia vaccines, Pneumovax23® and Prevnar13®, protect against the most common causes of bacterial pneumonia.
- Pneumovax23® protects against 23 different types of pneumococcal bacteria. It is recommended for all adults 65 years of age and older and children over 2 years of age who are at increased risk for pneumonia.
- Prevnar13® protects against 13 types of pneumonia bacteria. It is recommended for all adults 65 years of age and older and children under 2 years of age. Ask your healthcare provider about these vaccines.
If you have children, ask their doctor about other vaccines they should get. Several childhood vaccines help prevent infections caused by the bacteria and viruses that can lead to pneumonia.
How Can I Recover From Pneumonia Faster
If your doctor confirms that you have a mild case of pneumonia, you should treat pneumonia as you would a serious bout of cold or flu. Stay home, get plenty of rest, and drink fluids to stay hydrated and keep the mucus in your lungs loose. You should aim to drink six to eight cups of fluid each day.
You can also take over-the-counter painkillers such as paracetamol and ibuprofen these will not help you recover faster, but they will ease symptoms such as fever and chest pain. Its not recommended that you take cough medicines as there is little evidence to suggest that they are effective.
If you are a smoker, you should give up smoking while you are recovering from pneumonia and should aim to not smoke cigarettes once you are healthy again. We have an in-store service as well as stop smoking products that could help you cut down or quit smoking.
How Is Walking Pneumonia Different From Regular Pneumonia
Walking pneumonia differs from typical pneumonia in several ways, including:
- Walking pneumonia is a milder form of pneumonia.
- Walking pneumonia usually does not require bed rest or hospitalization.
- Walking pneumonia is usually caused by Mycoplasma pneumoniae. Typical pneumonia is most commonly caused by _Streptococcus _pneumonia or influenza virus or rhinovirus.
How Long Does It Take To Recover From Pneumonia
It can take a long time to fully recover from the effects of pneumonia. If your condition has been caused by a bacterial infection, starting antibiotic treatment should improve your condition. After a week or so, you should find that the worst of your symptoms have passed, however you may continue to feel unwell for weeks or months afterwards.
The average person who experiences pneumonia and is treated with antibiotics should find their symptoms improve in the following stages:
- One week on: fever subsided
- Four weeks on: chest pain and mucus production subsided
- Six weeks on: coughing and breathlessness subsided
- Three months on: most symptoms gone, but still feeling tired
- Six months on: back to normal health
What Are The Complications Of Pneumonia
Anyone can experience complications from pneumonia. However, people in high-risk groups are more likely to develop complications, including:
- Breathing difficulties: Pneumonia can make breathing difficult. Pneumonia plus an existing lung disorder can make breathing even more difficult. Breathing difficulties may require a hospital stay to receive oxygen therapy or breathing and healing assistance with the use of a breathing machine .
- Fluid buildup in the lungs : Pneumonia can cause a buildup in the fluid between the membranes that line the lungs and the inside of the chest cavity. It is a serious condition that makes breathing difficult. Pleural effusion can be treated by draining excess fluid with a catheter, chest tube or by surgery.
- Bacteria in the bloodstream : The bacteria that cause pneumonia can leave your lungs and enter your bloodstream, spreading the infection to other organs. This condition is treated with antibiotics.
- Lung abscess. A lung abscess is a pus-filled cavity in the lung that is caused by a bacterial infection. It can be treated by draining the pus with a long needle or removing it by surgery.