How pneumonia is treated?

Answer 1

It depends on the type of pneumonia. It can be viral, bacterial, fungal, parasitic, or due to inhalation of foreign substances. But, all types of infectious pneumonia require effective antimicrobial treatment of the specific organisms involved. All pneumonia types usually involve physiotherapy of lungs (respiratory therapy), and liquifaction and expectoration of secretions from the lungs using expectorant medications. Almost always in hospitalized patients, IV fluids are also needed to treat or prevent dehydration. Pneumonia is also often treated with IV or oral corticosteroids and/or oral NSAIDS to reduce the lung tissue inflammation, regardless of the type of pneumonia and organism or type of irritation or foreign substances involved.

Pneumonia from lung irritants and toxic inhalation:

Those with the types of pneumonia that are caused by irritation of the lung tissue (like aspiration pneumonia caused by choking on vomit, foods or liquids or being unable to swallow correctly; and pneumonia caused by inhalation of foreign substances like smoke inhalation or chemical inhalation, pollen for those allergic and/or with Asthma, dust or other particles in the air or substances inhaled in illegal drug use), will often acquire secondary bacterial infections along with the initial inflammation. Prophylactic (preventive) antibiotics may be given before infectious pneumonia manifests. Empiric antibiotics are usually started asap and then adjusted if necessary to fight the specific organisms better once the lab cultures are completed to identify the culprits.

Bacterial pneumonia:

This is the most common type of pneumonia treated in hospitals. Once the culture results are reported, primary bacterial pneumonia conditions are treated with antibiotics specific to the organisms involved in causing the infection. Antibiotics may be given orally for minor bacterial lung infections on an outpatient basis or, if severe symptomology, then treatment will likely be done in a hospital and the antibiotics will ordinarily be given by IV there.

Parasitic pneumonia:

Parasitic pneumonia is uncommon and most often seen only in immuno-compromised patients, like those with HIV/AIDS or patients after an organ transplant on suppressants. Treatment is usually antibiotics and sometimes corticosteroids. Your body must do most of the "treating ".

Viral pneumonia:

Viral pneumonia can be treated with anti-viral medications and treatment for any secondary "opportunistic" bacterial infections found. Antibiotics do not help directly cure pneumonia caused by viruses. Your body, again, must do the treating of most viral infections for itself. Any secondary bacterial organisms will be fought with antibiotics, as well as with symptomatic treatment of fever, etc. Prophylactic antibiotics, as mentioned above, may also be used, especially in hospitalized patients, who can be exposed there to antibiotic-resistant bacteria and less common and harder to treat types of pneumonia.

Fungal pneumonia:

Anti-fungal medications are given for the fungal pneumonias, and secondary bacterial infections can also accompany these types that will need antibiotic treatment, as well.

Other treatment measures:

Other treatments for all of these types of infectious pneumonia, as well as the pneumonia caused by irritants, smoke inhalation or breathing of other chemicals or foreign substances, involve lab monitoring of the arterial blood gases (ABG) and keeping the oxygen levels in the blood from going too low (from improper air exchange in the fluid-filled lungs). Treatment or prevention of hypoxia (low oxygenation) is also given by administration of oxygen at levels above plain room air (to increase the oxygen available in your blood for your body to use while the lungs are less effective or ineffective at exchanging the gases).

Additionally, respiratory therapy treatments ("breathing treatments", often with aerosolized medications), may be given to help loosen secretions, open swollen bronchial tubes and other airway passages, and aid expectoration.

Finally, symptomatic treatments for fever, cough, chest pains, dehydration and other measures for comfort and relief are provided. In rare extreme cases, respiratory failure may require use of a mechanical ventilator (usually only required short term).

More information:

Some pneumonias are more difficult to treat than others. Legionaires' Disease is an example of a pneumonia that is difficult to treat and cure. Legionaires' Disease is often caught from stale water pooled in and around large air conditioning units of buildings, if the systems have not been maintained properly. It is a debilitating disease that could take a healthy adult about 6 months to recover completely.

Common antibiotics used for pneumonia (not all-inclusive):

Bacterial Streptococcus pneumonia is often treated with penicillin, ampicillin-clavulanate (Augmentin) and erythromycin.

Bacterial pneumonia caused by the Hemophilus influenza bacteria (just the name of the bacterium, not the same as the common flu which is viral) is treated with cefuroxime (Ceftin), ampicillin-clavulanate (Augmentin), ofloxacin (Floxin), and trimethoprim-sulfanethoxazole (Bactrim and Septra).

Bacterial pneumonia caused by legionella pneumophilia and staphylococcus aureus bacteria are often treated with erythromycin.

Viral pneumonia does not respond to antibiotic treatment. This type of pneumonia usually resolves over time through the work of your body's immune system. If the lungs become infected with a secondary bacterial infection, the doctor will prescribe an appropriate antibiotic to eliminate the secondary bacterial infection and sometimes these are given prophylacticly to prevent a secondary bacterial infection.

Mycoplasma pneumonia is often treated with erythromycin, clarithromycin (Biaxin), tetracycline or azithromycin (e.g., Zithromax, Z pack).

Symptomatic treatment:

In addition to the pharmaceutical intervention, the doctor will also recommend bed rest, plenty of fluid intake, therapeutic coughing and deep breathing, breathing exercises and incentive spirometers, proper diet, cough suppressants, pain relievers and fever reducers (such as aspirin, only for those over age 18) or acetaminophen. In severe cases, oxygen therapy and artificial mechanical ventilation may be required.

Course of the disease:

The course of pneumonia varies. Recovery time depends upon the organism involved, the general health of the person and how promptly medical attention was obtained. A majority of sufferers recover completely within a few weeks, with residual coughing persisting between six and eight weeks after the infection has gone.

Diagnostics:

Evaluation of the condition for diagnostic purposes often includes:

Lung/Chest x-rays and CT scans.

Cultures of organisms - Your blood and sputum/phlegm may contain germs that will show up in the laboratory cultures after a few days so the specific germs can be targeted with the right antibiotics.

Your blood cell counts will be tested (CBC) and if you have more white blood cells (WBC) than usual, it may indicate/confirm that you have an infection. Other blood tests that can help doctors confirm the diagnosis may also be done, such as measurement of sedimentation rates (Sed Rate), levels of C-reactive proteins (CRP), arterial blood gases (ABG), etc.

You may also require testing to monitor the levels of antibiotics in your system for some types of antibiotics and in some patients (e.g., gentamicin that requires very accurate dosing based on these lab tests).