How to treat pneumonia

Many pneumonia patients are elderly people or children. This is because the elderly or children have insufficient immunity or some minor colds and fevers are not treated in time, causing pneumonia. There is a high possibility that children will be infected with pneumonia, because most children will suffer from fever and colds. However, some children are weaker and will get sick if they come into contact with cold things. If they are not treated well, they are prone to pneumonia. In the past, pneumonia could lead to death if it was not cured.

Death happens around us every moment, so parents with children at home should pay attention. It is summer again now, and many children like to eat cold things. Try to eat less or no cold things. These things are harmful to children when they are young. You can drink more boiled water to replenish the water in the body.

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.

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; 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.

Antimicrobial treatment of 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.

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 cells or a 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.

Generally speaking, young and middle-aged people rarely suffer from diseases such as pneumonia, so the elderly and frail people need more care in life. Otherwise, if the elderly develop diseases such as pneumonia, it will be very difficult to treat. In order to prevent the occurrence of pneumonia, everyone should pay more attention to the environment in which they live.