![]() Local patterns of antibiotic resistance always need to be considered when initiating pharmacotherapy. In North America, where the "atypical" forms of community-acquired pneumonia are becoming more common, clarithromycin, azithromycin, or fluoroquinolones as single therapy have displaced the amoxicillin as first-line therapy. In the United Kingdom, amoxicillin is used as first-line therapy in the vast majority of patients acquiring pneumonia in the community, sometimes with added clarithromycin. The antibiotic choice depends on the nature of the pneumonia, the microorganisms most commonly causing pneumonia in the geographical region, and the immune status and underlying health of the individual. Prevention of bacterial pneumonia is by vaccination against Streptococcus pneumoniae ( pneumococcal polysaccharide vaccine for adults and pneumococcal conjugate vaccine for children), Haemophilus influenzae type B, meningococcus, Bordetella pertussis, Bacillus anthracis, and Yersinia pestis.Īntibiotics are the treatment of choice for bacterial pneumonia, with ventilation (oxygen supplement) as supportive therapy. Other vitals such as pulse and body temperature are also checked.ĭepending on the general health, severity of the disease and age of the patient, several other tests may be required, such as: In some cases, pulse oximetry may also be required as pneumonia is known to deplete oxygen levels in the blood. This also plays a role in informing treatment options. ![]() A sputum sample will also be obtained to ascertain the causative bacteria. A chest X-ray may be performed to check for signs of inflammation and a complete blood count will also be obtained. Patient history is obtained, including the symptoms and their duration, as well as exposure to any risk factors of the disease. They can also travel to the area between the lungs and the chest wall, called the pleural cavity. The neutrophils, bacteria, and fluid leaked from surrounding blood vessels fill the alveoli and result in impaired oxygen transportation.īacteria can travel from the lung into the blood stream ( bacteremia) and can result in serious illness such as sepsis and eventually septic shock, in which there is low blood pressure leading to damage in multiple parts of the body including the brain, kidney, and heart. This results in the fever, chills, and fatigue common in bacterial and fungal pneumonia. The neutrophils engulf and kill the offending organisms but also release cytokines that result in a general activation of the immune system. This invasion triggers the immune system to respond by sending white blood cells responsible for attacking microorganisms ( neutrophils) to the lungs. Once inside the alveoli, bacteria travel into the spaces between the cells and also between adjacent alveoli through connecting pores. Often, bacteria live in parts of the upper respiratory tract and are continuously being inhaled into the alveoli, the cavities deep in the lungs where gas exchange takes place. Pneumococcal pneumonia can cause coughing up of blood, or hemoptysis, characteristically associated with "rusty" sputum īacteria typically enter the lung with inhalation, though they can reach the lung through the bloodstream if other parts of the body are infected. ![]()
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