What antibiotics are prescribed for pneumonia. Antibiotics for pneumonia - effective and safe medicines

They are bacterial in nature, so the only effective method of combating them is antibiotics. All over the world, doctors adhere to a single scheme: for community-acquired forms of pathology they prescribe drugs from the group of penicillins, macrolides and cephalosporins, for hospital-acquired forms - cephalosporins and fluoroquinolones. All of these medications have their own specific uses.

Penicillins

Antibiotics from the aminopenicillin group are effective against the most common pathogen of pneumonia, streptococcus.

The oldest group of antibiotics, with high activity and at the same time low toxicity to humans. Penicillins are effective against, including the most common pneumococcus (Streptococcus pneumoniae). All drugs of this class are bactericidal, that is, they cause the death of microbial cells. We looked at the application in detail different groups antibiotics in various groups of patients with pneumonia.

More often than others from the group are appointed:

1. Amoxicillin(trade names: “Flemoxin Solutab”, Hiconcil, Ospamox, Amoxicillin). It is administered orally in the form of capsules or suspensions. Frequency of administration: 2–3 times a day, depending on the dosage. The duration of treatment is from 10 to 14 days. In 10% of cases, amoxicillin is ineffective. This is due to the fact that some pneumonia pathogens have learned to produce substances - beta-lactamases that destroy the antibiotic.

1. Amoxicillin + clavulanic acid combination(trade names: Augmentin, Amoxiclav, Flemoklav Solutab, Amoxicillin with clavulanic acid). Clavulanic acid protects amoxicillin from the effects of beta-lactamases, thereby increasing its effectiveness against bacteria. Drugs with it, as a rule, are prescribed to patients who have had it more than once. Apply combination medications also – 2–3 times a day for 10–14 days.

While taking penicillins, the following may develop: side effects:

• allergic reactions(compared to other antibiotics, penicillins are more likely to cause urticaria, itchy skin, Quincke's edema),
• disorders from digestive tract(nausea, vomiting, diarrhea),

If any negative reaction occurs, you should stop using the drug and consult a doctor.

Due to their low toxicity, penicillins can be prescribed to children early age and pregnant women. Dosages for these categories of patients are selected strictly individually.

Macrolides

Another numerous and low-toxic class of antibiotics. Compared to penicillins, macrolides have a wider spectrum of action. Their use is also effective in cases of atypical pneumonia, the causative agents of which are mycoplasmas and chlamydia.

For adults, macrolides are available in the form of tablets and capsules, for children - in the form of suspensions. They act bacteriostatically, that is, they do not kill microbes, but inhibit their further reproduction. From side effects may cause:

• nausea, diarrhea, vomiting, abdominal pain,
• inflammation of the gums (stomatitis and gingivitis),
• allergic reactions (rare).

Doctors give preference to several drugs from this group, including:

1. Midecamycin (tradename Macropen). Apply 3 times a day for 1–2 weeks. The drug is well tolerated. At the discretion of the doctor, it can be used during pregnancy. Contraindicated in children under 3 years of age.

1. Azithromycin(Sumamed, Z-factor, Zitrolide). Frequency of administration: once a day. Duration of treatment – ​​3 days. Contraindicated in case of kidney and liver dysfunction.

1. Clarithromycin(Klabaks, Klacid). Taken 2 times a day for 6–10 days. Not prescribed for liver diseases and children under 6 months.

1. Roxithromycin(Rulid). It is recommended to take 2 times a day. The average duration of treatment is 5–10 days. Contraindicated during pregnancy, breastfeeding and children weighing less than 40 kg.

Bacteria can quickly develop resistance to macrolides, so doctors try to avoid long-term therapy with these drugs (more than 10 days).

Cephalosporins

The most common side effects of cephalosporins are digestive disorders and diarrhea.

An extensive group of natural and semi-synthetic drugs, similar in structure to penicillins, but active against more pathogenic agents. For community-acquired pneumonia, patients are usually prescribed oral cephalosporins:

• cefixime (Suprax, Pancef),
• ceftibuten (Cedex).

For hospital forms, intramuscular and intramuscular solutions are more effective. intravenous administration:

• cefuroxime (Zinacef),
• cefotaxime (Cephabol, Talcef),
• ceftriaxone (Forcef, Tercef).

Common side effects of cephalosporins include digestive disorders and allergic reactions. Rarely, convulsions, increased fatigue, stomatitis, and blood clotting disorders may occur. These drugs are prescribed with caution in the elderly and patients with kidney disease.

Cephalosporins can be used in children and, if necessary, in pregnant women (in the 2nd–3rd trimester). The average duration of treatment is 7–10 days.

Fluoroquinolones

A group of powerful synthetic antibiotics that are prescribed for severe forms of pneumonia. Fluoroquinolones are available in the form of tablets, capsules and solutions for drip administration. The specific form of the drug is selected by the doctor taking into account the patient’s condition.

1. Ofloxacin(Tarivid, Zoflox). It is prescribed orally or intravenously. In the first case, the drug is taken 2 times a day for 7–10 days. In the second, droppers are placed 1-2 times a day until the condition improves, then the patient is transferred to oral therapy.

1. Ciprofloxacin(Tsifran, Tsiprobay). The release form and dosage regimen are similar to ofloxacin.

Frequent negative reactions:

• nausea, vomiting, flatulence,
• headaches, dizziness,
• pain in joints and muscles,
• bleeding disorders,
• allergic reactions.

A significant disadvantage of fluoroquinolones is their ability to inhibit bone growth, and therefore they are not used in pregnant women and children under 18 years of age.

The program “Doctor Komarovsky’s School” talks about the use of antibiotics in the treatment and even prevention of pneumonia:

More than 10 million people die from pneumonia every year around the world. The health organization recommends the use of antibiotics for pneumonia caused by bacteria. Among the many groups of drugs, only the attending physician will determine the best remedy for the patient. For children under eight years of age, many groups of drugs are not used, since they negatively affect the child’s development, and for the treatment of resistant, hospital-acquired infections, drugs with a certain sensitivity to infection are used.

The effectiveness of antibiotics for pneumonia reaches 80%. This means that out of 100 patients, 80 were completely cured, which is a high figure. Improvement occurs after 2-3 days of use. In severe cases, this period increases.

Pneumonia: treatment with antibiotics

The therapeutic regimen for pneumonia is based on antibacterial agents, which are administered intravenously, intramuscularly or orally. The main goal of treating pneumonia with antibiotics is to create an optimal concentration of the drug to destroy pathogenic microbes.

Intensive care is provided in the hospital. Additionally, electrolytes, painkillers and detoxification drugs are administered. Intravenous administration of solutions allows you to remove toxins and products of active microorganisms and dissolve viscous sputum. As a result, headache and muscle pain are relieved, temperature decreases and the bronchi are cleansed.

Before prescribing antibiotics for pneumonia, a blood test is done. Severe leukocytosis indicates the need to prescribe antibacterial agents. To determine which antibiotic to prescribe to a patient, a sensitivity culture must be done. To do this, sputum, which is collected by the patient before antibiotics are prescribed, is sown on a nutrient medium in Petri dishes. Then the sensitivity of the grown colonies to a number of antibacterial agents is determined. The effect of antibiotics on the pathogen:

1. Streptococci are sensitive to penicillins (ampicillin), cephalosporins and macrolides.
2. Penicillins are also harmful to Haemophilus influenzae.
3. Macrolides, fluoroquinolones, and the tetracycline group are prescribed for mycopallasma and chlamydial pneumonia.
4. Pneumonia caused by Legionella is treated with macrolides, fluoroquinolones, and rifampicin or erythromycin.
5. Cephalosporins (cefotac, ceftriaxone) act on Klebsiela and Escherichia coli.

The choice of antibiotic also depends on the severity and age of the patient. At mild form In patients under 60 years of age, therapy can be prescribed on an outpatient basis.

Treating pneumonia at home

For the first three days, until the sensitivity of the bacteria is detected, broad-spectrum drugs are prescribed. In the absence of severe concomitant diseases, young and middle-aged adults are prescribed treatment for pneumonia at home. The following antibiotics are taken on an outpatient basis:

In more severe forms, complicated treatment, hospital care, intravenous administration, and a combination of drugs (summamed and tivanik, targotsida and meronem) are required. The best combination is determined after culture for sensitivity to antibiotics.

What antibiotics to take for pneumonia

The prescription of antibiotics depends on the type and causative agent of pneumonia. There are drugs that have a bactericidal effect only on a certain type of bacteria, some of the products have wide range and are prescribed for all types of pathogens. They are used on initial stages community-acquired pneumonia. The type of pathogen that causes hospital infections is isolated and determines which antibiotics to take for pneumonia. at this stage. For community-acquired pneumonia the following is prescribed:

• Macrolides – azithromycin, clarithromycin, erythromycin;
• Fluorochipolones – gemifloxacin, levofloxacin, moxifloxacin;
• Penicillins - amoxicillin, amoxicillin with clavunate (augmentin), ampicillin, piperacillin, timentin.

In severe cases, therapy is intensified with cefotaxime or clarithromycin. A combination of drugs brings good results.

Hospital-acquired pneumonia requires the following medications:

• Cephalosporins – cefaclor, cefadroxil, cefuroxime, cephalexin;
• Vancomycin.
• Tetracyclines – doxacycline.

A two-drug regimen is most often used: ceftriaxone and gentamicin or lincomycin. Antibiotics destroy bacteria or stop their growth and reproduction.

Antibiotic treatment for pneumonia: side effects

Every drug has side effects. All of them are set out in the manufacturer's instructions. You can get information about them from your doctor or pharmacist. What you need to know about side effects:

• You need to weigh the benefits and harms; there are many more positive aspects;
• The side effect disappears after stopping use;
• If the effect does not go away, further tactics should be agreed with your doctor.

Antibiotics can cause an allergic reaction, which is manifested by rashes and swelling of areas of the body. In such cases, you should stop taking it and consult a specialist. In what cases is an ambulance required:

• Shortness of breath with transition to suffocation;
• Swelling of the face, tongue and throat.
• Antibacterial drugs have side effects on the body in the form of the following symptoms:
• Dyspepsia (nausea, vomiting);
• Taste of metal on tongue;
• Dizziness.

Taking fluoroquinolones and tetracycline increases skin sensitivity to sunlight. During the course of treatment, you should avoid solarium and tanning. Sunscreen, in this case, does not block ultraviolet rays. During this period, open areas should be covered with clothing.

Studies have shown that certain types of antibiotics block liver enzymes (erythromycin), increasing the risk of sudden cardiac death. Gentamicin and vancomycin lead to hearing loss.

Treatment of pneumonia after antibiotics

If after a course of therapy the symptoms of pneumonia continue to bother you, then the reason is the use of drugs without sensitivity testing or incorrectly chosen ones. Often patients stop treatment on their own after their condition improves.

The regimen adopted by experts is to take an antibiotic until the temperature normalizes, and then for another three days. Depending on the severity, therapy continues for up to six weeks. If there is no positive dynamics, then re-seeding for sensitivity is carried out and the treatment is adjusted. Therefore, the reasons for relapse and re-treatment are as follows:

• Incorrectly selected drug;
• Frequent, short courses of antibiotics.

Self-medication leads to a weakening of resistance to infections and the emergence of bacterial resistance to drugs. Treatment of prolonged pneumonia is carried out in a hospital setting under x-ray monitoring. The antibiotic is selected until positive dynamics are achieved.

Treatment of pneumonia: a combination of antibiotics

It is better for the human body if one drug is administered. In this case, the load on the liver and kidneys is minimized. Therefore, the optimal prescription is one drug with a high bactericidal effect for a given type of microbe. Combined treatment is prescribed for the following aggravating cases:

• Severe condition or relapse;
• The presence of two or more types of pathogens;
• Weakened immunity due to cancer;
• The danger of drug resistance.

The scheme consists of two agents acting on different types of microorganisms.

Things to remember

Bacteria can become resistant to antibiotics. Resistance develops when the drug is used incorrectly or for too long. To prevent this, you need to complete the course of treatment, because bacteria that did not die immediately begin to multiply and develop resistance to antibiotics. Some drugs cancel each other out when combined. This happens when antibiotics are combined with bacteriostatic agents.

Antibiotics are one of the tools that can solve health problems. Taking medications incorrectly puts your health at risk. Only treatment under the supervision of a doctor, taking medications strictly as prescribed is the key to successful treatment today and in the future.

The main danger that can be expected from this disease is an extremely difficult physical condition and even death. That is why therapy must be timely. Pneumonia is mainly treated with antibiotics.

How does pneumonia develop? Classification

Most often, this disease occurs due to pathogenic microflora entering the respiratory tract: staphylococci, pneumococci, legionella, coli and others. In this case, inflammatory processes develop in the tissues of the respiratory organs. Also, pneumonia can be triggered by viral infections and certain toxic substances; rarely, pneumonia is a consequence of chest injury. There is a risk group that includes smokers, people who abuse alcohol, patients who have been on bed rest for a long time, as well as special old age. Depending on the type of pathogen, bacterial, viral, fungal and mixed pneumonia are distinguished. If one lung is affected, then they speak of unilateral inflammation. There may also be bilateral, total, lobar, segmental pneumonia. Depending on epidemiological data, the disease can be nosocomial, community-acquired, atypical, or caused by an immunodeficiency state.

Main symptoms of the disease

One of the main symptoms of the development of inflammatory processes in the lungs is coughing. Also, when breathing, you may feel characteristic pain and shortness of breath. Particularly acute painful sensations with deep breaths, coughing. Pneumonia causes a high body temperature. However, pneumonia is not always accompanied by an increase. The patient feels weakness throughout the body, fatigue, decreased appetite, possible nausea and even vomiting. Symptoms are especially severe in older people and children. All this suggests that to alleviate the condition and avoid the development of complications, it is necessary to start taking antibiotics for pneumonia. This disease has a peculiarity: antibacterial drugs are prescribed immediately, without waiting laboratory research. After receiving the results of the sputum analysis, treatment is adjusted.

Stages of the disease

Experts distinguish three degrees of severity of respiratory inflammation. Easy stage characterized by mild intoxication, body temperature is within 38 ºС, heartbeat is not accelerated. At the same time, the person maintains a clear consciousness. At x-ray examination a small affected area is detected. With a more severe degree, the temperature may increase to 39 ºС, and intoxication is more pronounced. Moderate tachycardia is observed, shortness of breath appears. Infiltration is clearly visible on x-rays. The most severe degree is characterized not only by high temperature (up to 40 ºС), but also by clouding of mind. A person may become delirious, and shortness of breath occurs even in a calm state. At the same time, the intoxication of the body is pronounced.

Antibiotic for pneumonia in adults

This group of drugs is aimed at destroying pathogenic flora. First of all, the specialist must suppress acute symptoms diseases. In this case, antibiotics are prescribed that have a wide spectrum of action.

The doctor then sends the sputum sample to the laboratory. The research results obtained influence further treatment. The specific pathogen that provoked the disease is determined. The specialist selects the necessary antibiotic for pneumonia in adults, the action of which will be aimed at destroying this microorganism. A combination of drugs is often required, since there may be several pathogens. For proper selection of medications, an antibiogram is used.

Antibioticogram

This test helps determine whether the patient's body is sensitive to a specific antibiotic. After all, the market is saturated with all kinds of drugs, and often bacteria show resistance to one type of drug, but are destroyed by another. The patient's sputum is required for the study. The sample is affected different drugs. During this analysis, the most effective antibiotics for pneumonia are selected for a particular patient. They will inhibit the growth of microorganisms. Weaker drugs will not interfere with their development. The accuracy of such research is high. The only drawback is that you need to wait a long time for the results: they will be ready after 2-5 days.

Groups of antibiotics used in the treatment of pneumonia

Most often, treatment of pneumonia with antibiotics begins with broad-spectrum drugs. These include penicillins, macrolides, tetracyclines, fluoroquinols, aminoglycosides, cephalosporins.

Penicillins are one of the first antibacterial drugs. They are natural and semi-synthetic. Penetrates well into body fluids and tissues. They can also cause a number of undesirable effects: diarrhea, hypersensitivity, allergic reactions. Treatment of pneumonia with antibiotics of this type is effective if the causative agents are streptococci and staphylococci.

Tetracyclines are drugs that are used less and less. The reason for this is the resistance of microorganisms to their action. Another peculiarity of the drugs is their ability to accumulate in bone tissue. However, they can lead to tooth decay. Therefore, such antibiotics for pneumonia are not prescribed to pregnant women, women during breastfeeding, young children, or patients who have kidney problems. Representatives of drugs of the tetracycline group are “Doxycycline”, “Tetracycline”.

Cephalosporin group

There are 4 generations of this type of medicine. First generation drugs include Cefazolin, Cephalexin, etc. They actively act on bacteria from the cocci group (pneumococci, staphylococci). The second generation of drugs has good antibacterial properties against both gram-positive and gram-negative flora. The half-life is approximately 1 hour. Cephalosporins, which belong to the third generation, have an excellent effect on microorganisms that are resistant to drugs penicillin group(“Cefotaxime”, “Cefoperazone”). They are used to treat severe forms of infections. Cefepime is the name of fourth generation antibiotics for pneumonia. They are the most active. Among the adverse reactions after taking cephalosporins, allergies are most often identified. About 10% of patients report allergic reactions to these drugs.

Macrolides. Aminoglycosides

Macrolides are used to neutralize cocci, legionella, and chlamydia. They are well absorbed into the body, but food intake somewhat slows down this process. Allergic reactions are very rare. Representatives of this category are drugs such as Erythromycin, Azithromycin, Clarithromycin. Their main area of ​​application is infectious processes in the respiratory tract. However, liver dysfunction is a contraindication to taking such medications.

Aminoglycosides are antibiotics for pneumonia that actively act on aerobic gram-negative microorganisms. They are also used in cases where the disease is caused by more than one type of bacteria, and therefore it is necessary to combine antibacterial drugs to achieve desired result. Representatives of the group are drugs such as Gentamicin and Amikacin. The dosage is calculated depending on the patient’s body weight, age, and severity of the disease. When taking such drugs, control of glomerular filtration in the kidneys is necessary.

Class of quinols and fluoroquinols

Medicines in this category are divided into 4 generations. Non-fluorinated (this is the first generation) actively affects legionella and E. coli. They have a somewhat less effect on chlamydia and cocci. First generation drugs are used for mild infections. The remaining quinols (second to fourth generation) are fluorinated. All medications are well distributed in the body. They are excreted from the body primarily by the kidneys. The main contraindications for use are the period of pregnancy and hypersensitivity to the drug. In addition, the use of non-fluoridated drugs is undesirable for patients who have problems with the liver or kidneys. Fluoroquinols are not prescribed to children (under 18 years of age). The only exception may be the absence of an alternative option. This class includes drugs such as Ciprofloxacin, Pefloxacin, Levofloxacin. These medications are administered intravenously only by drip.

What are the rules for prescribing antibacterial drugs?

If pneumonia is diagnosed, only a specialist decides which antibiotics to take. After you start using medications, you can replace them with others. The indications for this are serious side effects that may occur during treatment with certain drugs. Also, replacement occurs if the doctor does not observe the desired result (and changes in better side should appear on the second or third day). Some antibiotics are quite toxic. Therefore, their reception cannot last long. In general, treatment of pneumonia in adults with antibiotics lasts 10 days. But more serious infections require a much longer period of time (about a month). The specialist must take into account the general condition of the patient, the presence of certain concomitant and chronic diseases, and the person’s age. When prescribing antibacterial drugs, it is also important to be able to create a dose of the drug in the blood that will be sufficient for the given severity of the disease.

In what forms are antibiotics used?

Depending on the stage of the disease and the severity of its course, various methods of administering drugs are used. Mostly in the first days of illness, medications are administered by injection. Cephalosporin (antibiotics for pneumonia) injections are given intravenously or intramuscularly. This is possible due to their low toxicity. The peculiarity of macrolides is that they accumulate and continue to act even when the medication is stopped. Mild forms of the disease are treated within 10 days. In this case, antibiotics for pneumonia in tablets can be used. However, experts say that the oral form of medication is not as effective. This is because it is difficult to calculate the exact dosage. It is not recommended to frequently change medications, as this may develop resistance of microorganisms to antibiotics.

Features of the treatment of pneumonia in children

Pneumonia is especially dangerous for young patients. The disease can occur even in children. The main symptoms of pneumonia in young patients are wheezing, coughing, difficulty and rapid breathing, high temperature (which lasts quite long time). It is worth paying attention to the baby’s behavior. He loses his appetite, becomes lethargic and restless. The most important symptom of pneumonia in young children is a blue discoloration of the area between the lips and nose. As a rule, pneumonia occurs as a complication after acute respiratory viral infections, and not as an independent disease. There are also congenital pneumonia(pathogen is herpes virus, mycoplasma), infection can occur directly during or after childbirth. In newborns, the airways are small and gas exchange is less intense. Therefore, the disease is more severe.

Antibiotics and children

As for adults, the mainstay of treatment for pneumonia in children is antibiotics. For pneumonia in children, they are administered parenterally. This makes it possible to minimize the impact of drugs on the microflora of the digestive system. It is also possible to take medications by injection or inhalation. The last method is the most comfortable for young children. If the child’s age does not exceed 6 months, then treatment is carried out exclusively in a hospital, where the baby is under the constant supervision of specialists. The course of therapy for children is 7 days when taking drugs of the penicillin group, cephalosporins. If the doctor prescribed macrolides (this could be Azithromycin, Clarithromycin), then the duration of treatment is reduced to 5 days. Antibiotics for pneumonia in children should show effectiveness within 3 days. Otherwise, the drug may be replaced.

Under no circumstances should you self-medicate. Even the best antibiotics for pneumonia, which helped one child, may be ineffective or even dangerous for another. It is very important to strictly adhere to your medication schedule. You should not take synthetic vitamins and other immunomodulatory drugs at the same time. To prevent the occurrence of pneumonia, you should avoid hypothermia and promptly treat colds and other infectious diseases. Don't forget about proper balanced nutrition.

Antibiotics for pneumonia - effective and safe medicines

Inflammation of the lungs begins immediately with chest pain when breathing, severe cough with sputum, and fever. The disease urgently requires hospitalization. The patient is prescribed bed rest, special vitamin nutrition, and the main component of the therapeutic process is treatment with antibiotics.

What is pneumonia

Pneumonia is popularly called pneumonia. This is an infection of the lower respiratory tract With incubation period from 2 to 10 days, which involves lung tissue. There are several types of disease:

1. Atypical. Caused by chlamydia, legionella, mycoplasma, that is, atypical microflora.
2. Aspiration. It occurs when water, food or foreign objects enter the respiratory tract.
3. Hospital. The disease develops while the patient is in the hospital.
4. Out-of-hospital. Occurs as a complication after surgery viral infection. It is often a cause of death due to a severe decrease in immunity.

New generation antibiotics help to avoid complications of pneumonia, which can cause lung abscess, pleural empyema, pneumothorax and other serious diseases. The most serious consequence pneumonia is a respiratory failure. This pathology develops in patients with other chronic diseases or in elderly patients who are not adequately treated with antibiotics. Failure often causes death.

Nail fungus will no longer bother you! Elena Malysheva tells how to defeat the fungus.

Losing weight quickly is now available to every girl, Polina Gagarina talks about it >>>

Elena Malysheva: Tells you how to lose weight without doing anything! Find out how >>>

Antibiotics for pneumonia

Given the acute course of the disease, broad-spectrum antibacterial drugs are prescribed without waiting for laboratory tests. Doctors distinguish three degrees of severity of pneumonia. At the mildest stage, intoxication of the body occurs (mild), the patient’s body temperature does not exceed 38°C, the heart beats in a normal rhythm. The patient remains conscious, and X-ray examination reveals a small focus of inflammation localized in the upper lobe of the lung.

In the severe stage, the body temperature immediately increases to 39°C, tachycardia (moderate), intoxication is observed, infiltration is clearly visible on the X-ray. The most severe degree of pneumonia (pleuropneumonia) is characterized by a body temperature of 40°C, the patient is delirious, suffers from shortness of breath, and intoxication is pronounced. Antibiotics are prescribed for pneumonia, taking into account the following factors:

• stage and severity of the disease;
• drug toxicity;
• contraindications;
• possible manifestation of allergies;
• antibiotic action spectrum;
• the speed of penetration of the drug into the body;
• rate of development of bacterial resistance to this drug.

Penicillins

The first antibacterial drugs that quickly penetrate tissues and fluids, so they are used for congestive pneumonia. If the causative agent of inflammation is staphylococci or streptococci, then treatment with drugs of this type is effective. When pathology occurs for another reason, other antibiotics are prescribed. Penicillins are administered orally (tablets, suspensions) and through injections (injections). Penicillins include:

Tetracyclines

A group of drugs used in the treatment of pneumonia is becoming increasingly rare. Their instability to the action of microorganisms and the ability to accumulate in tissues is the reason. Tetracyclines have many contraindications: pregnancy, lactation, age under 7 years, kidney disease. Known representatives of this group of antibiotics:

Cephalosporins

They actively act on all bacteria of the cocci group, have excellent antibacterial properties against gram-negative and gram-positive flora, and have an effect on microorganisms that are resistant to drugs of the penicillin group. Adverse reactions include allergies. The intravenous or intramuscular method of administering the drug is used. Antibiotics in this group include the following drugs:

Macrolides

This group of antibiotics for pneumonia is used to neutralize chlamydia, legionella, and cocci. Macrolides are well absorbed, but food intake can slow down the process. Side effects and allergic manifestations are extremely rare. Contraindications include liver disease in patients. Representatives of this category of drugs:

Aminoglycosides

Act on gram-negative aerobic microorganisms. They are used when pneumonia is caused by several types of bacteria, so therapy is prescribed along with antibacterial or antiviral drugs. For example, the effect of the antibiotic Amikacin in atypical pneumonia will be enhanced by the antibacterial Metronidazole. When coadministered, the glomerular filtration rate in the kidneys (excretory capacity) should be monitored. Representatives of the group are:

Fluoroquinols

Medicines actively affect E. coli and Legionella. Today, fluoroquinols occupy one of the leading positions in the treatment of bacterial pneumonia. These are broad-spectrum drugs with the ability to penetrate deeply into tissues. Resistance of microorganisms to fluoroquinols rarely develops due to structural changes in DNA and permeability of the bacterial wall. Known antibiotics of this group:

How to treat pneumonia with antibiotics

Only the doctor decides which antibacterial drugs to take. Self-treatment of pneumonia at home can be fatal. Antibiotic therapy is carried out for no more than 10 days, since many drugs are toxic. For bilateral pneumonia, treatment can be extended for a longer period. The specialist takes into account the general condition of the patient, his age and dosage form drug. A dosage of antibiotic in the blood is needed for it to be effective for a given degree of disease.

In adults

After 18 years of age, antibiotics are prescribed for pneumonia in a dosage calculated individually. For an adult, a doctor may prescribe the use of one drug or several groups of antibacterial agents. Medicines are mainly used in ampoules, because some modern drugs, for example, Ceftriaxone, are not available in tablets. In addition, experts say that antibiotics are more effective if you inject them rather than drink them.

If after 3 days there is no therapeutic effect, the doctor should replace the medicine with another group of antibiotics. Frequently changing medications is also not recommended, so as not to develop resistance of microorganisms to them. When the cause of inflammation is a virus, immunomodulators are additionally prescribed:

In children

Childhood pneumonia is especially dangerous, because it occurs latently after acute respiratory viral infections, and not as an independent disease. The child becomes lethargic, loses appetite, coughs, wheezing, and high fever appear. The basis of pediatric therapy is also antibiotics, which are administered parenterally. Children are prescribed natural and semi-synthetic penicillins or macrolides, in which the duration of treatment lasts no more than 5 days. Previously, pediatricians do a sensitivity test to the antibiotic prescribed for the child.

Video: Treatment of pneumonia with antibiotics

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

Antibiotics for pneumonia in adults

The drug of choice for pneumonia in adults is the beta-lactam penicillin antibiotics amoxicillin + clavulanic acid (drugs with the names Augmentin, Flemoklav solutab). Antibiotics are produced in tablet form, which allows them to be used as prescribed by a doctor at home and for children.

Groups of antibiotics for pneumonia

Pneumonia is caused by pathogens of several groups. Especially often, community-acquired pneumonia (occurring outside the walls of the hospital, as opposed to a hospital infection) is provoked by Streptococcus pneumonia, Haemophilus influenza, Staphilococcus aureus, Pseudomonas aeroginosa and other protozoa, including mycoplasma, legionella, chlamydia.

There is no single antibiotic that can act equally effectively on all pathogens of pneumonia; for each type of infection, the most effective drug is empirically selected.

Several groups of antibiotics are used to treat pneumonia:

It is impossible to differentiate which antibiotics are the best for pneumonia and which are ineffective, since in each case the outcome of treatment is determined not only by the type of pneumonia pathogen, but also by the reactivity of the immune system, concomitant chronic diseases, and care features.

Beta-lactam antibiotics

The main drugs for the treatment of pneumonia are beta-lactam antibacterial agents, combined based on the presence of a beta-lactam ring in the molecule.

The drugs have a similar mechanism of action and differ in sensitivity to beta-lactamase enzymes, which are produced by bacteria.

Amoxicillin antibiotics are highly effective against pneumococci, which often cause pneumonia; in the absence of allergies, they serve as the drug of choice in children and pregnancy.

Beta-lactam drugs include:

• penicillins;
  • natural – benzpenicillin, oxacillin;
  • ampicillin;
  • amoxicillins – Hiconcil, Flemoxin solutab;
  • inhibitor-protected – Augmentin, Timentin;
  • antipseudomonal ureidopenicillins – azlocillin, piperacillin;
• cephalosporins;
  • 1st generation – cefazolins (Kefzol, Cefamezin), Cephalexin;
  • 2nd generation – products with cefuroxime (Zinnat, Ketocef);
  • 3rd generation – cefotaxime (Claforan), ceftriaxone (Rocephim), ceftazidime (Fortum);
  • 4th generation - cefepimes (Maxipim).

Beta-lactam antibacterial agents are highly effective, but can cause allergies, which is why they are replaced with macrolides or fluoroquinolones. Macrolides are the drugs of choice for suspected atypical form, which is caused by chlamydia, legionella, mycoplasma.

The advantages of these antibacterial agents include a significant post-antibiotic effect, in which a high concentration of the drug is created in the blood, which remains in a therapeutic dose after discontinuation of the drug.

For example, Azithromycin has a post-anibiotic effect of 4 days, which allows the course of therapy to be reduced to 5 days.

Features of community-acquired pneumonia

Pneumonia can develop rapidly, leaving no time to conduct diagnostic tests to determine pathogenic microflora. The first prescription of an antibiotic and private clinic, and is done empirically in a public hospital.

When choosing which antibiotics to take, the doctor proceeds from the clinical picture of the disease, the prevalence of pneumonia pathogens in the area, the most typical pathogens, and the presence of a history of chronic diseases in adults.

Treatment of pneumonia is carried out in tablet forms; the drugs of choice are penicillins and 2nd generation cephalosporins. Treatment in the form of injections is resorted to when treatment with tablets is impossible, as well as when the disease is severe.

Thus, hospital forms of pneumonia in adults begin to be treated with the administration of antibiotics in injections, and switch to taking tablets only on the 3rd day after the symptoms of inflammation have subsided.

Treatment of pneumonia in adults at home

The effectiveness of the antibiotic is assessed 3 days after the start of therapy. During this time, the necessary therapeutic concentration is created in the blood, and the medicine acts with maximum results.

For mild pneumonia caused by pneumococci and streptococci, oral medications are used containing:

• amoxicillins - Amoxicillin Sandoz, Flemoxin Solutab, Hiconcil, Amosin, Ospamox - 0.5 g at intervals of 8 hours;
• amoxicillins + clavulanate – Augmentin, Betaklav, Flemoklav Solutab, Ecoclave, Amoxiclav – 0.65 g, intervals - 8 hours;
• Cefuroxime axetil - dosage 0.5 g, intervals - 12 hours.

If there is no result after 3 days of use, there is a possibility of atypical pneumonia, adults are prescribed:

• tetracyclines - Doxycycline orally 0.1 g at intervals of 12 hours;
• macrolides:
  • clarithromycin - Klacid, Fromilid, Fromilid Uno, Romiclar, Clarithromycin Sandoz, Clarbact 0.5 g at intervals of 12 hours;
  • azithromycin - Sumamed, Azitral, Hemomycin, Zitrolide Forte, Azitormicin Zentiva, Azitrox, Zitorlide 0.5 g 1 day once, subsequent days - 0.25 g 1 time per day;
  • midecamycin – Macropen 0.4 g after 8 hours;
  • spiramycin – Spiramycin-Vero, Rovamycin 3 million IU at intervals of 12 hours;
  • roxithromycin - Brilid, Rulid, Rulitsin, Esparoxi 0.15 every 12 hours;
  • erythromycin – 0.5 g at intervals of 6 hours Erythromycin tablets;
  • josamycin – Vilprafen, Vilprafen solutab 0.5 g with an interval of 8 hours;
• Fluoroquinolones:
  • gatifloxacin – Zarquin, Gatispan 0.4 g 1 time/day;
  • levofloxacin - Tavanic, Flexid, Floracid, Levolet, Glevo 0.5 g 1 time per day;
  • moxifloxacin - Avelox, Hynemox 0.4 g 1 time / day.

Pneumonia in the elderly

For pneumonia in adults over 65 years of age with a mild form, protected aminopenicillins Augmentin or Amoxiclav, Cefuroxime Axetil or one of the fluoroquinolones in the usual dosage are prescribed from the first day of treatment.

Alternative drugs for elderly patients are Doxycycline or Cefaclor.

Pneumonia during pregnancy

During pregnancy, women with pneumonia must be hospitalized. Antibacterial drugs are used in pregnant women only when indicated.

For treatment, medications are chosen that have the maximum effect, but do not cause harm to the developing fetus.

Acceptable antibiotics for the treatment of pneumonia during pregnancy include:

• amoxicillins - table. 0.5 g at intervals of 8 hours;
• amoxicillin + clavulanate – after 8 hours;
• cefuroxime axetil – 0.5 g every 12 hours;
• ampicillin – 1 g injection every 6 hours;
• ceftriaxone - 1 g injection at intervals of 24 hours;
• cefutaxime - 1 g injection at intervals of 8 hours;
• cefuroxime – injections 1.5 every 8 hours.

An alternative drug for allergies to beta-lactam penicillins in pregnant women is spiramycin, which is prescribed for oral administration after 12 hours in a suspension of 3 million IU.

Severe pneumonia

For severe community-acquired pneumonia, Cefepime, Ceftriaxone or Cefotaxime are prescribed as the drug of choice. In addition to the main drug, an antibiotic from the macrolide group is used - clarithromycin, spiromycin or erythromycin.

The most severe course of pneumonia is observed when infected with staphylococcus, pneumococcus, enterobacteria, and legionella. In severe forms of inflammation, medications are administered intravenously; pairs of drugs are used:

• amoxicilling + clavunate and macrolide injection;
• cefotaxime + macrolide;
• ceftriaxone + macrolide;
• ciprofloxacin (ofloxacin) + 3rd generation cephalosporin (or levofloxacin, moxifloxacin).

Replacing antibiotics

The effect of using an antibiotic is to reduce the symptoms of intoxication and lower the temperature. If this does not happen after 3 days, then the drug is replaced.

Ampicillin is often the drug of choice; if there is no result, it is replaced with a macrolide or added additionally. And in case of severe pneumonia, instead of ampicillin, a macrolide + one of the 3rd generation cephalosporins is used.

If the patient was immediately prescribed amoxicillin or cefuroxime, then to achieve the effect, a drug from the macrolide group is added to it.

The reason for changing the antibiotic may be developing renal failure in a patient due to nephrotoxicity of the drug. Nephrotoxic drugs include cephalosporins and fluoroquinolones.

Perhaps you were looking for information about what traditional medicine says regarding pneumonia - read the article Folk remedies from pneumonia in adults.

How long does therapy last?

Provided the temperature normalizes within 4 days, the total duration is days. The duration of the course for mycoplasma pneumonia is 2 weeks.

If infected with enterobacter, staphylococcus, legionella, the course of treatment can be extended to 3 weeks.

Recovery criteria

Signs of normalization of the patient’s condition are:

• temperature reduction to values ​​not exceeding 37.5 0 C;
• decrease in respiratory rate to 20 or less breaths per minute;
• absence of pus in the sputum;
• reduction of signs of intoxication of the body.

The use of antibiotics serves an important, but only one purpose - the destruction of infection. The task of restoring lung function is solved by drugs from other groups - anti-inflammatory, expectorant, bronchodilator drugs. The overall result of treatment depends on the correctly chosen treatment regimen, age, and immunoreactivity of the patient.

Enterovirus infection in children - symptoms, diagnosis and treatment

How to treat enterovirus infection in adults

Is it possible antiviral drugs taken together with antibiotics

Antiviral drugs for influenza and ARVI

Why is your nose stuffy but not a runny nose?

Complex nasal drops for children

By self-medicating, you can waste time and harm your health!

Copying materials is permitted only with an active link to the site. Everything is in the original texts.

The most effective and common antibiotics for pneumonia

Pneumonia is a serious and quite severe infectious disease. It manifests itself as damage to the respiratory system. Antibiotics for pneumonia are effective because the drugs kill the bacteria that cause the inflammation.

If you do not use antibiotics for pneumonia, the desired effect will not be achieved. This happens because the immune system is unable to cope with harmful microbes on its own. But it is worth considering that using an antibiotic for pneumonia on your own is dangerous, since the treatment is accompanied by a number of side effects.

Antibioticogram

Using this analysis, you can determine the sensitivity of the patient’s body to a particular drug. Such an analysis is necessary because the market is full of different drugs. It happens that harmful organisms show resistance to one type of antibiotic, while another type is able to destroy them. To carry out the analysis, sputum is taken from the patient and appropriate studies are performed using various drugs. Based on the results of such actions, the most effective drug is identified, with which therapy is prescribed to the patient. Strong drugs can destroy harmful bacteria, while weak ones can prevent their reproduction. The research is accurate, there are no mistakes. The analysis period takes about 5 days, so antibiotics are pre-prescribed that can curb the progression of the disease.

Thanks to this analysis, the risks of side effects and negative consequences, including allergic reactions from the use of antibiotics, are reduced. The predicted positive outcome from the prescribed treatment is also determined by this analysis, because by identifying the pathogen and the antibiotic affecting it, you can be guaranteed to receive positive result from treatment.

Use of antibiotics for pneumonia in adults

Antibiotics for pneumonia in adults destroy pathogenic flora. To prescribe treatment, it is necessary to reduce the acute symptoms of the disease with the help of antibiotics that have a broad effect.

Often, adult patients with pneumonia are prescribed the following antibiotics:

After this, the attending physician needs to take the patient’s sputum for analysis and, based on the results obtained, prescribe the most effective therapy. The laboratory identifies the specific type of bacteria that provoked the inflammatory process. After this, a medicine is prescribed to destroy these particular species. pests. Sometimes a combination of drugs is required due to the identification of several types of harmful organisms.

Use of antibiotics for pneumonia in children

A serious illness in children is pneumonia, for which antibiotics are prescribed even to children. Reveal this disease quite possible even in a baby. Symptoms of the disease: wheezing, coughing, difficulty breathing, elevated temperature. Also dangerous symptoms indicating the development of pneumonia are: loss of appetite, lethargy, drowsiness or, conversely, hyperreactivity. Blue skin in the area under the nose is a sign of pneumonia, and antibiotics are prescribed immediately. In children, this disease can occur as a result of acute respiratory viral infection. It is worth considering that the course of the disease in children is more complex due to the small airways.

Children are treated with gentler drugs:

To treat a disease in children such as pneumonia, antibiotics are initially prescribed. In this case, it is selected best view a drug that can kill harmful bacteria and cause fewer side effects.

An antibiotic can destroy the child’s microflora, so it is necessary to additional tests to select the most optimal therapy for each individual case.

Antibiotics used to treat pneumonia

A person has quite predictable questions: what to treat, what antibiotics to take, what drugs to stock up on for pneumonia, and what method of treatment is the most effective?

Penicillins are called the primary means of destroying bacteria. Such agents tend to penetrate organ tissue. But they can also cause adverse reactions in the form of: diarrhea, hypersensitivity, allergic reaction. They have good effectiveness in the fight against staphylococci and streptococci. Tetracyclines are not used as often as penicillins. It has to do with sustainability. large quantity microorganisms to this drug. Also, a negative side of these drugs is their ability to accumulate in bone tissue. In addition, the use of these products leads to tooth decay.

Group of cephalosporins

This type of product has four generations of release. First generation cephasporins quickly fight coccal bacteria. Generation II drugs destroy gram-positive and gram-negative bacteria. The withdrawal period does not exceed 60 minutes. Generation III of such drugs copes well with microorganisms that are resistant to penicillins. They are used to suppress infection. IV generation drugs, the newest ones, are able to cope with all kinds of groups of microorganisms. But these drugs have quite a lot of side effects, for example, about 11% report allergic reactions to such a strong antibiotic. The latest generation of drugs cope better with bacteria.

Macrolides, aminoglycosides

Thanks to the use of macrolides, cocci, legionella, and chlamydia are neutralized. The drug has the property of being well absorbed into the body. Such drugs are used for respiratory infections.

Aminoglycoside drugs for pneumonia are used when it is necessary to influence gram-positive bacteria during pneumonia. The drug helps well in the treatment of diseases caused by one type of microorganism. To achieve a positive effect if there is various types bacteria requires a combination of treatments. The dosage of such drugs is calculated based on body weight, the number of years of the patient and the stage of pneumonia. During use, monitoring of proper kidney function is required. Take medications as prescribed by the doctor.

Class of quinols and fluoroquinolones

Drugs called quinols, like cephalosporins, are divided into 4 generations. Generation I of these antibiotics kills E. coli and works quite well against Legionella. They have a less effective effect on coccal bacteria. Generation II medications are prescribed for minor infections. The most effective therapy is using III and IV generation of agents. The new generation medicine is well absorbed into the organs. The drug is excreted through the kidneys. The best antibiotics with pneumonia belong to the last generation.

Fluoroquinolones are prescribed only to persons over 18 years of age. An exceptional case there is a lack of alternative. These drugs are effective against gram-positive and gram-negative microorganisms. They destroy not only pneumococci, but also salmonella. Intracellular bacteria are quickly destroyed by fluoroquinolones. Intravenous administration is carried out only using a dropper. Treating pneumonia with these drugs is quite effective.

Rules for prescribing antibiotics for pneumonia

The decision on the use of drugs is made by the doctor after examination. Medicines may be replaced with others during therapy. The conditions for changing the prescribed antibiotic are a strong undesirable effect that may occur with a particular medicine. The specialist can also change the drug, provided that the previous one did not give the required result. The positive effect of taking antibiotics should appear after 2-3 days. There are antibiotics for pneumonia that are toxic. As a result, such funds are not prescribed for a long period of time.

Toxic drugs include the following groups:

• aminoglycosides;
• sulfonamides;
• nitrofurans.

On average, antibiotic treatment for pneumonia lasts about 14 days. If pneumonia is intensified by additional diseases, then treatment may last until the patient fully recovers. It is also important to determine the general health of the patient.

Ineffective treatment of pneumonia with antibiotics

Failure to treat a lung infection with antibiotics is quite rare. The source may be the patient’s self-medication before contacting the medical institution. So, if the patient took any other drugs, then the effectiveness of the drugs for pneumonia is significantly reduced.

It may also be ineffective if:

• repeatedly use antibiotics;
• constant replacement of antibiotics;
• bacteria have developed resistance;
• incorrect dose selection;
• incorrect choice of the duration of the therapy period.

In such circumstances, a combination of drugs is performed. Also, treating the patient with other drugs can give effective results. Antibiotics for the treatment of pneumonia in tablets and capsules may be ineffective, since treating pneumonia with this method is effective only at the early stage of the disease. It is recommended to take antibiotics in tablet form as a preventive measure for the disease. Take the tablets with plenty of water.

Quite serious and dangerous disease– pneumonia, treatment with antibiotics gives good results. This disease must be cured immediately, since in the early stages the treatment period is fewer days, and the drugs prescribed are more gentle, with minimal side effects. In more serious cases Pneumonia is quite difficult to treat. Even use strong drugs does not always give a positive result.

Only a qualified specialist can draw up a treatment plan.

Antibiotics for pneumonia provide effective treatment illness and complete recovery of the patient. The use of such drugs should be carried out under the supervision of a specialist, often in a medical facility.

The importance of using antibiotics for pneumonia

Antibiotics are indispensable drugs that allow for high-quality treatment of pneumonia. Without effective antibiotic therapy, it is quite problematic to cure a patient, and the rapid progression of the disease leads to severe complications and even death.

Other medications prescribed to a patient with pneumonia play a role aids, aimed at enhancing treatment, relieving symptoms, reducing the likelihood of side effects and accelerating recovery.

Antimicrobial medications are used after a detailed examination of the patient’s biomaterial (blood, urine, sputum). Clarifying the type of microorganisms that provoked the development of the disease allows you to select the most effective medicine.

Most often, the pathology is caused by pathogens included in the list below:

• staphylococci;
• streptococci;
• pneumococci;
• enterobacteria;
• chlamydia;
• mycoplasma;
• Haemophilus influenzae;
• Moraxella.

The duration of antibiotic therapy and the amount of medications the patient receives is determined by the attending physician based on the characteristics of the pathological process. In addition to the type of pathogen, the doctor takes into account the severity of the disease, the nature of the focal lung lesion, and the individual characteristics of the patient.

Groups of antibiotics prescribed for pneumonia

Modern medicine does not use simple penicillins, which were previously used for pneumonia. Today, pulmonologists prescribe more effective and safe drugs, having minimal toxic effects on the body.

When starting treatment for pneumonia, the doctor chooses effective drugs from the number:

• cephalosporins (Cefotaxime, Ceftriaxone);
• macrolides (Azithromycin, Clarithromycin);
• carbapenems (Meropenem, Imipenem);
• semisynthetic penicillins (Amoxicillin, Amoxiclav).

Cephalosporins will help cure uncomplicated pneumonia caused by the activation of pneumococci, streptococci, and enterobacteria in the human body. They are also used if the patient is allergic to macrolides and penicillins. Drugs of this type are ineffective against E. coli and Klebsiella.

Macrolides are relevant in diagnosing atypical pneumonia, pneumonia occurring against the background of acute respiratory infections, and intolerance to penicillin. Chlamydia, mycoplasma, and hemophilus influenzae are sensitive to this group of medications.

Carbapenems are used to treat complicated forms of the disease, as well as when cephalosporins are low in effectiveness. Semi-synthetic penicillins are prescribed for mild degree pneumonia of viral-bacterial origin. This type of medicine is effective against Haemophilus influenzae and pneumococci.

In some cases, specialists resort to prescribing fluoroquinolones and monobactams. However, these antibiotics do not become the first choice drugs for pneumonia in adults.

Principles of treatment with cephalasporins

A cephalosporin called Cefotaxime is used for intramuscular or parenteral administration (into a vein). The antibiotic can be used during the neonatal period, in the first and second trimesters of pregnancy. The drug is not recommended for use during breastfeeding.

For adult patients, the drug is administered according to the following regimen:

1. Average degree inflammatory process in the lungs - 2 g every 8-12 hours.
2. Severe form of pneumonia - 2 g every 4-8 hours.

For intravenous administration, the drug is diluted with saline or 5% glucose solution. To perform injections into the muscle, Cefotaxime is combined with Lidocaine (1%).

Side effects of therapy with this antibiotic can include changes in blood composition, headaches, allergic reactions, anemia, vomiting, and stool disorders.

Ceftriaxone is a complex drug that belongs to a new generation of potent antibiotics. Like Cefotaxime, this drug is administered intravenously or intramuscularly. Before injections, the powder is dissolved in Lidocaine or water for injection.

There is the following common regimen for the treatment of pneumonia in adults using Ceftriaxone - 2-4 g once or twice every 24 hours.

Ceftriaxone is tolerated without complications in most cases. Sometimes the drug causes side effects in the form of vomiting, dysfunction of the gastrointestinal tract, and deterioration in general health.

Cephalosporin antibiotics are contraindicated for use in cases where the patient has liver or kidney failure, or is allergic to active substance drugs.

Treatment of pneumonia in adults with macrolide antibiotics

Azithromycin tops the list of the most popular macrolides in the treatment of pneumonia. For patients over 6 years of age and adults, the drug is prescribed in capsules.

The minimum course duration with Azithromycin is 3 days. Patients over 12 years of age take the drug once a day (1 capsule of 500 mg).

Azithromycin is a long-acting drug, and therefore it is prohibited to independently make changes to the dosage regimen. It is also not recommended to take the medicine more than twice a day.

Side effects of antibiotics do not develop often. The list of possible negative consequences of taking capsules includes:

• conjunctivitis;
• neuroses;
• drowsiness;
• bronchospasms;
• skin rash;
• disruptions in the functioning of the gastrointestinal tract;
• candidomycosis.

Clarithromycin is a worthy representative of macrolides, occupying the second position in frequency of prescription after Azithromycin. The regimen for using both drugs is largely similar. When treating pneumonia, adults receive 250-500 mg of the drug once a day. Therapy is carried out for 6-14 days.

Both macrolides have a wide spectrum of action and a similar list of contraindications. Azithromycin and Clarithomycin are not prescribed for serious illnesses liver and kidneys, intolerance to the composition of these medications. The use of both products in the treatment of pneumonia in lactating patients and women during pregnancy is not recommended.

Carbapenems are the second choice drugs for pneumonia

Meropenem, like cephalosporins, is available in powder form for preparation. injection solution. This tool used for monotherapy or combination treatment of pneumonia in cases where there is no significant effect from the use of first-choice antibiotics.

There are age restrictions regarding the use of this medicine. Thus, Meropenem is not suitable for the treatment of pneumonia in patients younger than 3 months. The drug is used to a limited extent during pregnancy and lactation. If it is necessary to carry out antibiotic therapy in nursing patients, it is necessary to temporarily transfer the baby to artificial nutrition.

Scheme for parenteral use of the drug: adults and patients over 12 years of age - 500 mg at 8-hour intervals. The duration of the treatment course is determined individually.

Serious side effects from the use of the drug are rare. In some patients, the antibiotic can cause tachycardia, itching and rashes on the skin, insomnia, abdominal pain, nausea and diarrhea. To exclude the occurrence of negative reactions of the body to the administration of the drug, it is not prescribed for acute and chronic diseases. gastrointestinal tract, in the first 90 days of life of newborn babies, with individual intolerance to the active substance.

Features of the use of semi-synthetic penicillins

Despite the variety of modern antibiotics, penicillin drugs remain one of the options for treating pneumonia. In pulmonology, it is important to use semi-synthetic drugs that have a gentle effect on the patient’s body.

Amoxicillin can be used in the treatment of various categories of patients, except women who are breastfeeding. The drug helps to effectively fight pneumonia at various stages of its development. Depending on the doctor's instructions, the medicine is taken orally or administered intravenously.

Antibiotic tablets are taken at a time independent of food intake. For adults, the medicine is prescribed 500 mg-0.75 g three times a day.

The duration of therapy is determined by the severity of the disease. It can vary between 5 days - 2 weeks.

If there are indications for intravenous or intramuscular administration, Amoxicillin is prescribed 500 - 1000 mg to adult patients 2 times every 24 hours. The course of injections can take from 1 week to 10 days. After disappearing clinical signs disease, the drug is administered for another 2-3 days.

Amoxiclav is a two-component antibiotic, the composition of which is a combination of amoxicillin and clavulanic acid. The drug is available in tablets and powder, which can be used to prepare an injectable formulation.

Adults take Amoxiclav for pneumonia in accordance with standard mode daily dosage:

• for mild illness - 250 mg (+125 mg) three times a day;
• moderate pneumonia - 500 mg (+125 mg) twice a day;
• complicated form of the disease - 875 mg (+125 mg) 2 times a day.

If it is necessary to use an antibiotic in injections, adult patients receive the drug in a single dose of 1.2 g. Between doses of the drug into the body, 6-8 hour intervals are strictly observed. A course of antibiotic therapy for moderate pneumonia lasts 7-10 days. In more severe cases, treatment is extended to 2-3 weeks.

Side effects from the use of semisynthetic penicillins are uncommon. Sometimes patients receiving Amoxicillin or Amoxiclav develop allergic reactions in the form of itching, urticaria or rash, and extremely rarely - anaphylactic shock.

To minimize the risk of negative effects, it is recommended to test for hypersensitivity to penicillins before starting therapy.

General recommendations for patients taking antibiotics

When taking antibiotics during pneumonia, it is important to follow some recommendations:

Most doctors advise taking courses of multivitamins simultaneously with antibiotic therapy. This helps strengthen the immune system and speed up recovery.

Pneumonia is acute illness infectious-inflammatory nature of various etiologies(mainly bacterial), characterized by the presence of focal lesions of the lung tissue, as well as intra-alveolar exudation, manifested by:

• severe intoxication and respiratory syndromes;
• the appearance of local physical changes in the lungs;
• infiltrative shadows of the chest organs on radiography.

Many patients believe that pneumonia and pneumonia are different diseases, however, this is not the case. Pneumonia is inflammation of the lungs. The term pneumonia always implies inflammation of the lung tissue, as well as the presence of exudation in the alveoli, small-caliber bronchi, bronchioles, as well as damage to interstitial tissue.

It should be noted that pneumonia can only be acute process. Chronic pneumonia does not exist.

Antibiotics for pneumonia are the mainstay of treatment. Antiviral therapy It is advisable only for proven viral (in the vast majority of cases influenza) pneumonia.

Antibiotics for pneumonia are prescribed taking into account the spectrum of the main pathogens. If the antibiotic therapy is ineffective within 48 hours, it is recommended to change the antibiotic or add a second drug.

For severe pneumonia, two antibacterial drugs are immediately prescribed.

It should be noted that severe pneumonia is considered a special form of the disease. This is due to the fact that severe pneumonia is accompanied by severe intoxication, hemodynamic disturbances and the development of severe respiratory failure. Sepsis and septic shock are also possible. The prognosis for severe pneumonia is always unfavorable, so such patients always require mandatory intensive care.

Timely prescribed antibiotics for pneumonia significantly reduce the risk of an unfavorable outcome, as well as the development of severe complications, such as:

• pulmonary abscesses;
• gangrene of the lung;
• sepsis and septic shock;
• pleural empyema;
• endocarditis, pericarditis, myocarditis;
• acute respiratory failure (respiratory failure) and pulmonary edema, etc.

It is necessary to understand that pneumonia is dangerous infection, which at proper treatment has a favorable outcome. However, only the attending physician should prescribe antibiotics for pneumonia. Self-medication can be dangerous to health and cause the development of severe life-threatening complications.

Treatment of pneumonia at home in adults and children

Treatment of pneumonia at home can be carried out only after examination by a doctor and the appointment of appropriate therapy, if there are no indications for hospital treatment.

It should be noted that about 80% of patients (including older children) with community-acquired pneumonia can be treated at home, as well as in a day hospital.

Indications for treatment in a hospital are:

• the patient’s age is less than six months or older than 65 years (this category of patients has too high a risk of developing DN and other complications, so treatment should be carried out only in a hospital setting);
• severe pneumonia;
• presence of pregnancy;
• suspicion of atypical pneumonia;
• the patient has underlying diseases that can aggravate the course of pneumonia and cause complications. Patients with congenital heart defects, cystic fibrosis, bronchopulmonary dysplasia, bronchiectasis, immunodeficiency conditions, diabetes mellitus, etc. are subject to hospitalization;
• patients who have recently graduated or are this moment receiving immunosuppressive therapy;
• pneumonia is treated with antibiotics within 48 hours to no avail, with clinical symptoms progressing. Those. in an adult patient, fever persists, respiratory failure increases, etc.;
• lack of conditions for treatment at home (children from disadvantaged families, boarding schools, patients living in hostels, etc.) are hospitalized.

Is pneumonia contagious?

Yes, pneumonia is contagious. Pneumonia refers to respiratory infections. The most common route of transmission is airborne. A contact-household mechanism is also possible through shared utensils. Intrauterine hematogenous infection is extremely rare.

Risk groups include:

• young children with intrauterine hypoxia, asphyxia, birth trauma, cystic fibrosis, congenital heart defects or lung development, malnutrition and hypovitaminosis, immunodeficiency states;
• smokers;
• patients with chronic lung diseases or frequent bronchitis;
• immunodeficient patients;
• persons suffering from alcoholism or drug use;
• patients with lesions chronic infection (chronic tonsillitis etc.);
• patients with underlying pathologies ( diabetes or other endocrine diseases, kidney disease, cardiovascular pathologies, etc.);
• patients working with toxic substances, miners, shop workers (occupational risk factors);
• patients over 65 years of age;
• low-income persons.

Types of pneumonia

According to morphology, pneumonia is divided into:

• focal, characterized by one or more pneumonic infiltration foci from 1 to 2 centimeters;
• focal-confluent, accompanied by the development of heterogeneous massive foci of infiltration. This type of pneumonia can be complicated by destructive complications or exudative pleurisy;
• segmental (pneumonic focus occupies one segment of the lung);
• polysegmental, accompanied by damage to several segments. As a rule, such pneumonia is accompanied by atelectasis and a decrease in lung size;
• lobar (lobar), characterized by damage to the entire lobe of the lung (lobar pneumonia);
• interstitial (infiltration pneumonic foci are accompanied by damage to the interstitium). This form of pneumonia is rare, mainly in patients with immunodeficiencies;
• total, affecting the entire lung.

Pneumonia can be unilateral or bilateral.

It is necessary to distinguish between community-acquired and nosocomial pneumonia (developing within 48-72 hours after hospitalization due to another disease).

Depending on the severity, pneumonia is classified into mild, moderate and severe.

Severity of pneumonia

In mild cases of the disease, there is mild intoxication, fever up to 38 degrees, leukocytosis from 9 to 10 * 10 9 /l, the volume of pneumonic infiltration occupies 1-2 segments, there are no accompanying “background” pathologies, tachycardia up to 90 beats per minute. Respiratory failure is not expressed, cyanosis of the nasolabial triangle is absent or appears after coughing, physical activity (walking, climbing stairs, etc.).

The moderate course is characterized by more severe intoxication, signs of respiratory failure - cyanosis of the nasolabial triangle, respiratory rate 25-30 per minute, flaring of the wings of the nose, retraction of the pliable places of the chest (intercostal spaces, supra- and subclavian fossae), tachycardia up to one hundred beats per minute, high fever.

At severe course The patient's condition is serious, it is noted high fever, severe DN (cyanosis, shortness of breath, hypoxemia, etc.), hemodynamic disorders, decreased blood pressure, possible septic shock, pulmonary edema, renal failure and other complications.

Symptoms of pneumonia in adults

Pneumonia in adults is manifested by general intoxication symptoms (fever, chills, weakness, muscle pain, joint aches). As well as a sharp, significant increase in temperature, dry (possible at the onset of the disease) or wet cough(characteristic purulent, sticky sputum, at severe cough blood streaks may appear). Cyanosis of the nasolabial triangles and swelling of the wings of the nose may occur.

There may be noisy breathing and wheezing audible from a distance.

Symptoms of pneumonia in a child

Pneumonia presents basic symptoms similar to those in adults. Symptoms of respiratory failure in children tend to be more severe. Infants typically experience noisy, grunting breathing. Coughing attacks are often accompanied by vomiting (this is especially typical for children in the first years of life). There is also tearfulness, lethargy, the baby refuses to eat, and is capricious. With a strong cough, complaints of abdominal pain may occur.

Mycoplasma pneumonia in children (as well as chlamydial or legionella pneumonia) is characterized by a dry, sonorous, often with a metallic tint, obsessive cough, headaches, myalgia, sore and dry throat, nasal congestion, enlarged tonsils and lymph nodes, hoarseness, abdominal pain . The darkening on the radiograph is minimal, there is an increase in the pulmonary pattern, and, as a rule, interstitial changes are characteristic.

Diagnosis of pneumonia

Symptoms of pneumonia (pneumonia) in adults and children are described

Diagnosis of pneumonia is based on the patient’s complaints, examination data, laboratory and instrumental studies.

Pneumonia is characterized by:

• shortening of percussion sound;
• decreased breathing;
• increased bronchophony and vocal tremors;
• the appearance of dry (at the beginning of the disease) and wet (small, medium and large bubble) wheezing, as well as crepitus;
• identification of pneumonic foci (darkening) on ​​a chest x-ray;
• leukocytosis, high ESR, leukocyte shift to the left. Classic pneumococcal pneumonia is characterized by neutrophilic leukocytosis above 15*10 9 /l; with atypical pneumonia, children in the first months of life may experience leukocytosis above 30*10 9 /l;
• increase in C-reactive protein and other acute-phase proteins.

The main bacterial pathogens of pneumonia

Pathogen	Age
	newborn	1-3 months	4 months-4 years	from five years
Pneumococcus	+	+++	++++	+++
hemophilus influenzae	+	+	+	+-
Streptococcus pyogenes (a type of group A beta-hemolytic streptococcus)	—	+	+	+
staphylococcus	++	++	+	+
Streptococcus agalactia	+++	+	—	—
Escherichia coli	++	+	—	—
mycoplasma	—	+	+	++++
chlamydia pneumonia	—	+	+	++
legionella	+	+	+	+
chlamydia trachomatis	+	++	—	—
pertussis stick	+-	++	+	+

Very common pathogen, +++common, ++ relatively uncommon, + rare.

Name of antibiotics for pneumonia in adults

All antibiotics for pneumonia must be prescribed by your doctor. Self-medication is unacceptable.

Antibiotics for pneumonia in adults in tablets - list

Aminopenicillins

• (, Ecobol ®, Amoxisar ®, );

Inhibitor-protected penicillins

• Amoxicillin + clavulanic acid (,).

Macrolides

• ( , );
• (, Ecositrin ®);

Cephalosporins

• (, Cemidexor ®, Cefspan ®, Sorcef ®, Ixim Lupine ®);
• ( , Aksef ®).

Tetracyclines

Fluoroquinolones

• (Levolet ®,);
• ( , ).

Antibiotics for pneumonia in adults in injections

If necessary, inhibitor-protected drugs (azithromycin, ciprofloxacin, levofloxacin) can be administered intramuscularly or intravenously.

• (Zinacef ®);
• (Medakson ®, Lendatsin ®, Rofecin ®);

If inflammation caused by bacterial strains capable of producing bacterial betalactamases is suspected, inhibitor-protected penicillins (amoxicillin and clavulanic acid preparations) are used.

Augmentin ® for pneumonia can be used for the treatment of both children and adults.

For adult patients, as well as children who have previously been treated with amoxicillin or ampicillin, for pneumonia, it is recommended to immediately prescribe Amoxiclav ®, Augmentin ®, Flemoklav ®, etc.

Also, strictly according to indications, in case of resistance to other antibiotics, lincosamides (lincomycin ®, clindamycin ®) can be prescribed.

Additional treatments

Antibiotics for pneumonia are a mandatory component of treatment. Mucolytic agents are also used (ACC ® , Ambroxol ® , Lazolvan ® ). For dry cough, Sinekod ® is prescribed.

According to indications (temperature above 38-38.5), antipyretics (paracetamol ®, Nurofen ®, ibuprofen ®) are used.

For viral or mixed pneumonia, antiviral drugs (oseltamivir ® , zanamivir ® ) can be used.

Patients with severe respiratory failure Inhalations with Berodual are indicated; oxygen therapy can be performed.

According to indications, infusion therapy is prescribed to reduce intoxication and eliminate hemodynamic disorders.

Physiotherapy is also effective.