Posted on September 27th, 2008 in
Articles
Groshan Fabiola asked:
There are available dozens of antibiotics to treat pneumonia in or out the hospital, sometimes is hard even for the physician to select the best drug. To determine which is the antibiotic that suits best the physician has to determine the micro organism that caused the infection. If the penumonia is more severe than it should be treated in the hospital with intravenous antibiotics. But if it is moderate then it may be treated at home with oral antibiotics. What about the organism that causes the pneumonia? The micro organism that determined the pneumonia might be unknown and in this case the physician guess the most likely organism causing the pneumonia.
Some organism may be atypical or typical, so pneumonias caused by Streptococcus pneumoniae , Haemophilus influenzae , or Moraxella catarrhalis which have been treated with standard antibiotics and penicillin, but using the same antibiotics on Legionella, Mycoplasma, or Chlamydia which are atypical organisms would be a mistake. Another thing that must be taken into account is that individuals have different reactions which depend on age, health, size, and other factors. Certain antibiotics may produce allergies, bacteria may6 present resistence to others.
Treatment for atypical pneumonia
For children and young people with atypical pneumonia: erythromycin, clarithromycin, or azithromycin are the best choice. Newer quinolones may be effective on Legionella and severe atypical pneumonias. For bacterial community-acquired pneumonia which is produced by Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, or Moraxella catarrhalis macrolides or newer fluoroquinolones are used as treatments.
More severe cases of bacterial community-acquired pneumonia are treated with extended-spectrum penicillins, third-generation cephalosporins, those drugs are not effective on Legionella or Chlamydia. Pseudomonas aeruginosa and Klebsiella pneumonia, require specific therapy and doctors suggest fourth-generation cephalosporin and multidrug therapy. To prevent and treat the respiratory syncytial virus (RSV) pneumonia in children we use: Palivizumab which is a monoclonal antibody and immune globulin. Ribavirin, bronchodilators are suggested in the treatment of respiratory syncytial virus (RSV) pneumonia.
Antibiotics and their side effects
Almost all antibiotics produce gastrointestinal distress, they double the risk of vaginal infections in women, allergic reactions of various intensity , interactions between drugs should be taken into consideration too.
Antibiotic classes
Beta-Lactams have action on the bacterial cell walls, they include penicillins, cephalosporins. Penicillins, Amoxicillin high effect on the S. pneumoniae bacteria. Amoxicillin-clavulanate works on a wide spectrum of bacteria. Cephalosporins are used on gram-positive organisms, gram-negative bacteria. Carbapenems cover a wide spectrum of bacteria. Fluoroquinolones stopps the reproduction of bacterias, Ciprofloxacin, levofloxacin, sparfloxacin , gemifloxacin, and gatifloxacin. Moxifloxacin, trovafloxacin, and clinafloxacin are of fourth generation and inhibate gram-negative and gram-positive bacteria.
Macrolides are effective against S. Pneumoniae, tetracyclines have some side effects, but they inhibit bacterial growth.
Trimethoprim-Sulfamethoxazole is used in adults who are allergic to penicillin.
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