Is chronic inflammation of both lungs serious?

The occurrence of pneumonia is generally closely related to infection, and it can be a unilateral or bilateral disease. When pneumonia first appears, the symptoms are not very obvious, but the disease progresses very quickly. Once missed, the condition will rapidly worsen, and patients will often experience symptoms such as difficulty breathing, impaired consciousness, drowsiness, dehydration, and loss of appetite. So, is chronic inflammation of both lungs serious?

Pneumonia must be treated promptly, as severe cases can lead to respiratory failure and even death. Be sure to take it seriously.

Pneumonia treatment

1. Anti-infection treatment is the most important part of pneumonia treatment. Treatment of bacterial pneumonia includes empirical therapy and treatment directed at the pathogen. The former mainly selects antimicrobial drugs that may cover pathogens based on the epidemiological data of pneumonia pathogens in the region or unit; the latter selects antimicrobial drugs that are sensitive in in vitro tests based on the culture and drug sensitivity test results of respiratory or lung tissue specimens. In addition, the selection of antimicrobial drugs and routes of administration should be based on the patient's age, underlying diseases, aspiration, whether the patient is in a general ward or intensive care unit, length of hospitalization, and severity of pneumonia.

2. For young and middle-aged patients with community-acquired pneumonia without underlying diseases, penicillins and first-generation cephalosporins are commonly used. Due to the high resistance rate of Streptococcus pneumoniae to macrolide antibiotics in China, macrolide antibiotics are not used alone to treat pneumonia caused by this bacteria. Fluoroquinolones (moxifloxacin, gemifloxacin and levofloxacin) that are specifically effective for respiratory infections can be used for resistant Streptococcus pneumoniae.

3. For the elderly, patients with underlying diseases or community-acquired pneumonia who require hospitalization, fluoroquinolones, second- and third-generation cephalosporins, β-lactam/β-lactamase inhibitors, or ertapenem are commonly used, and can be combined with macrolides.

4. Second- and third-generation cephalosporins, β-lactam β-lactamase inhibitors, fluoroquinolones or carbapenems are commonly used for hospital-acquired pneumonia.

5. The treatment of severe pneumonia should first select broad-spectrum strong antibiotics, and should be used in sufficient doses and in combination. Because the initial empirical treatment is insufficient or unreasonable, or the antimicrobial drugs are adjusted according to the etiological results, the mortality rate is significantly higher than that of those with correct initial treatment. Severe community-acquired pneumonia is often treated with β-lactams combined with macrolides or fluoroquinolones; fluoroquinolones and aztreonam are used for those who are allergic to penicillin. Hospital-acquired pneumonia can be treated with fluoroquinolones or aminoglycosides combined with any of the anti-Pseudomonas β-lactams, broad-spectrum penicillins/β-lactamase inhibitors, or carbapenems, and, if necessary, with vancomycin, teicoplanin, or linezolid.

6. Antimicrobial treatment for pneumonia should be started as early as possible, and the first dose of antibiotics should be given immediately if pneumonia is suspected. Once the condition stabilizes, the patient can switch from intravenous to oral therapy. The course of antibiotic treatment for pneumonia is at least 5 days, and most patients require 7-10 days or longer. Antibiotics can be discontinued if the body temperature remains normal for 48-72 hours and there are no clinical unstable signs of pneumonia. The clinical stability criteria for pneumonia are: ①T≤37.8℃; ②heart rate≤100 times/min; ③respiratory rate≤24 times/min; ④blood pressure: systolic pressure≥90mmHg; ⑤arterial oxygen saturation≥90% or PaO2≥60mmHg under breathing room air conditions; ⑥able to eat orally; ⑦normal mental state.

7. The condition should be evaluated 48-72 hours after antimicrobial treatment. Effective treatment will be manifested by a decrease in body temperature, improvement in symptoms, a stable clinical state, a gradual decrease in white blood cell count or return to normal, and delayed absorption of lesions on chest X-rays. If symptoms do not improve after 72 hours, the possible reasons may be: ① the drug fails to cover the pathogenic bacteria, or the bacteria are resistant to the drugs; ② infection with special pathogens such as Mycobacterium tuberculosis, fungi, viruses, etc. ③ Complications occur or host factors that affect efficacy (such as immunosuppression) exist. ④ Non-infectious diseases are misdiagnosed as pneumonia. ⑤Drug fever. It needs to be carefully analyzed, necessary inspections made, and appropriate treatments taken.