Pneumonia is the development of inflammatory changes in lung tissue. This is due to the ingress of microbes (mainly bacteria, but there may be viruses and fungi) in various ways. The danger of pneumonia is that at the same time a more or less extensive area of the lung is turned off from the gas exchange process, which reduces the delivery of oxygen to the tissues. In addition, the body is poisoned by products of inflammation and destruction of the pulmonary parenchyma.
Inflammation of the lungs can develop:- in community-acquired conditions (such pneumonia is called "community-based");
- a person undergoing treatment in a hospital for any other disease;
- arising due to neurological disorders (convulsions, loss of consciousness), as a result of which the contents from the stomach got into the respiratory tract (aspiration pneumonia) ;
- in people with reduced immune defenses.
Depending on which of the four species is observed in this case, and also considering the age and presence of chronic diseases, treatment for pneumonia in adults is prescribed.
How does a microbe enter the lungs?
1) On the bronchi:
- if aerosol is densely seeded with pathogenic microbes in them. This is more common for tuberculosis or viral pneumonia ;
- by inhaling the contents of your own mouth and throat. This process occurs almost always during deep sleep, intensifies when taking sleeping pills or under the influence of alcohol. Normally, the local immune defense of the lungs works, but when it is weakened by the action of the virus, when there are too many microbes or they are very aggressive, pneumonia occurs.
2) Through the blood from another focus of inflammation. For example, from bone - with osteomyelitis, from heart valves - with endocarditis.
3) By contact:
- when pus gets from an adjacent organ, for example, with an abscess of the liver;
- with penetrating wound of the chest.
Principles for the treatment of pneumonia in adults
If the diagnosis of pneumonia is established, this implies the appointment of one or two antibiotics, since even if the cause was a virus (for example, the influenza virus), the bacterial flora joins in any case.
In theory, an antibiotic would have to be prescribed after the microbial pathogen of inflammation has been determined, and its sensitivity to drugs has been obtained. But this requires mandatory coughing up sputum, which not every patient can do, as well as a 4-5-day expectation of results, which is unacceptable. Loss of time can lead to death of the patient. Therefore, antibiotics are prescribed empirically, preferably after a person has passed sputum for bacteriological examination, but on the same day and preferably at the same time as the diagnosis was established (there is evidence that the loss of even 4 hours of time significantly worsens the prognosis).
The treatment of pneumonia in adults is based on the following criteria:- Type of pneumonia: community-acquired, arising inside a hospital or another.
- The volume of lung tissue lesion: segmental, lobar, multisegmental, single or double-sided.
- Patient's condition: taking into account his general well-being, shortness of breath, blood pressure level, degree of blood oxygen saturation.
- Age.
- The presence of concomitant pathology of the heart, lungs (for example, chronic bronchitis), kidneys.
Treatment is carried out at home or in the hospital in the department of therapy or pulmonology. Sometimes hospitalization in the intensive care unit is required.
Pneumonia: diagnosis
The classic
symptoms of pneumonia are fever (above 38 ° C),
cough with sputum, and general condition (weakness, drowsiness, loss of appetite). But now pneumonia with an atypical course is common. Against the background of a high or not very elevated temperature, diarrhea or
impaired consciousness, delirium, hallucinations may appear. In this case, the cough may not be completely.
Therefore, the diagnostic standard is a chest radiograph, and computed tomography may also be necessary.
Adult pneumonia treatment with antibiotics
The following antibiotics are used for treatment: Amoxiclav, Cefix, Sumamed, Levofloxacin, Avelox. They are prescribed in tablets, their combination is often used. For example, in the course of moderate severity, such a complex of drugs may be prescribed: Sumamed plus Avelox or Leflox. If the disease caused Klebsiella, pneumonia treatment involves inpatient treatment. In this case, intravenous and intramuscular preparations are prescribed, such as Amikacin, Gentamicin, together with Leflocin or Tavanik medicines.