Health guidance for chronic obstructive pulmonary disease

The incidence of COPD has become very high nowadays. This is mainly because people nowadays do not know how to take good care of their bodies, which causes their lungs to be infected. The incidence rate will become higher with age, and the severity will become more serious. Then after it occurs, we can only take antibacterial drugs for treatment, which has the best treatment effect.

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.

Penicillins, first-generation cephalosporins, etc. are commonly used for young and middle-aged patients with community-acquired pneumonia without underlying diseases. Due to the high resistance rate of Streptococcus pneumoniae to macrolide antibiotics in my country, 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.

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

Hospital-acquired pneumonia is often treated with second- or third-generation cephalosporins, β-lactam β-lactamase inhibitors, fluoroquinolones, or carbapenems.

The treatment of severe pneumonia should first select broad-spectrum, powerful 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

Patients allergic to penicillin should use fluoroquinolones and aztreonam. 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.