Limitation Of This Review
As to the designs of the studies, most of them reported that a significant portion of patients were still in hospital by the end of the study ). This may have led to an overestimation of the total rate of antibiotic use and secondary infections. Furthermore, classifications regarding patients severity were heterogenous, rendering comparison between articles difficult. Only a limited number of published articles was included, mostly from Republic of China and this could have impacted the results. Nonetheless, we provided the rate of severe patients in each study, as this variable is critical to determine relevance of antibiotic use. Regarding types of secondary bacterial and co-infections, we decided to report the available results, although little information was presented.
When Should You See A Doctor
If you have asthma or chronic obstructive pulmonary disease you should ask your doctor for advice. They may have given you recommendations about increasing your inhaler medication or taking a ‘rescue pack’ of antibiotics and steroid tablets at the first sign of an infection. If not, speak with them for advice if you develop symptoms of a chest infection.
There are a number of symptoms that mean you should see a GP even if you do not have any other lung problems. They include:
- If a fever, wheezing or headache becomes worse or severe.
- If you develop fast breathing, shortness of breath, or chest pains.
- If you cough up blood or if your phlegm becomes dark or rusty-coloured.
- If you become drowsy or confused.
- If a cough lasts for longer than 3-4 weeks.
- If you have repeated bouts of acute bronchitis.
- If any other symptom develops that you are concerned about.
What About Hospital Treatment
Hospital admission may be advised if you have severe pneumonia, or if symptoms do not quickly improve after you have started antibiotic treatment. Also, you are more likely to be treated in hospital if you are already in poor health, or if an infection with a more serious infecting germ is suspected. For example, if infection with Legionella pneumophila is suspected. Even if you are in hospital, you are likely to be offered antibiotics in capsule, tablet or liquid form unless you have difficulties taking them, in which case they may be given through a vein. Your antibiotic treatment will be stopped after five days, unless you are very unwell.
Sometimes oxygen and other supportive treatments are needed if you have severe pneumonia. Those who become severely unwell may need treatment in an intensive care unit.
When you return home, even though the infection is treated, you may feel tired and unwell for some time.
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Middle East Respiratory Syndrome Coronavirus
A new cause of severe pneumonia was first reported in Saudi Arabia in September 2012. Within a year, 58 cases, including 33 deaths, were reported in Jordan, Qatar, Saudi Arabia, the United Arab Emirates , France, Germany, Italy, Tunisia, and the United Kingdom. Since 2012 there have been over 1730 cases. The World Health Organization warns this new viral illness could become a pandemic. However, person-to-person transmission has been limited to close contacts. In the United States, no cases of MERS have been reported since 2014.
Occupational And Regional Pneumonias
Exposure to chemicals can also cause inflammation and pneumonia. Where you work and live can put you at higher risk for exposure to pneumonia-causing organisms.
- Workers exposed to cattle, pigs, sheep, and horses are at risk for pneumonia caused by anthrax, brucella, and Coxiella burnetii .
Inhalation or respiratory anthrax is a life-threatening infectious disease caused by inhaling the spores of the bacterium Bacillus anthracis. Although the spores are dormant when breathed in, they germinate when exposed to a warm, moist environment, such as the lungs. Not all particles are small enough to pass into the alveoli, or air sacs, but those that do begin to multiply and may spread to the lymphatic system. When the spores germinate, several toxins are released. Particles illustrated are not to scale.
- Agricultural and construction workers in the Southwest are at risk for coccidioidomycosis . The disease is caused by the spores of the fungi Coccidioides immitis and Coccidiodes posadasii.
- Those working in Ohio and the Mississippi Valley are at risk for histoplasmosis, a lung disease caused by the fungus Histoplasma capsulatum. This fungus grows well in areas enriched with bird or bat droppings.
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Before Taking This Medicine
You should not use Levaquin if you are allergic to levofloxacin or other fluoroquinolones .
Levaquin may cause swelling or tearing of a tendon , especially in the Achilles’ tendon of the heel. This can happen during treatment or up to several months after you stop taking levofloxacin. Tendon problems may be more likely in certain people .
Tell your doctor if you have ever had:
tendon problems, bone problems, arthritis or other joint problems
blood circulation problems, aneurysm, narrowing or hardening of the arteries
heart problems, high blood pressure
a genetic disease such as Marfan syndrome or Ehler’s-Danlos syndrome
low levels of potassium in your blood .
Do not give this medicine to a child without medical advice.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant.
You should not breast-feed while using this medicine.
Antibiotic Treatment For Ventilated Patients With Pneumonia
BackgroundVentilators are machines that breathe for patients. The ventilator tube goes into the mouth and through the windpipe. Sometimes there are bacteria on the ventilator tube that infect the patient’s lungs, leading to a disease called ventilator-associated pneumonia. Ventilator-associated pneumonia can cause significant harmful effects, and can sometimes lead to death. When treating people with ventilator-associated pneumonia, doctors must decide which antibiotic therapy to prescribe, usually without knowing the particular type of bacterial infection. This decision is important because inappropriate initial treatment may increase risk of harmful effects and longer hospital stays.
Search dateWe searched for studies to December 2015.
Study characteristicsWe looked at studies involving adults aged over 18 years who were treated in intensive care units for ventilator-associated pneumonia and needed antibiotic treatment. We analysed 12 studies with 3571 participants.
Key resultsAll included studies looked at the use of one antibiotic treatment plan versus another, but these varied among studies. There was potential for bias because some studies did not report outcomes for all participants, and funding for many was provided by pharmaceutical companies and study authors were affiliated with these companies.
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Does Pneumonia Show Up On A Test For Lung Cancer
Pneumonia and lung cancer often go through the same tests. However, the tests typically done for pneumonia are only preliminary diagnostic tools when it comes to testing for lung cancer. Because of this, pneumonia will likely be diagnosed prior to a person having the more intricate tests for lung cancer.
Looking In The Garden
Over the centuries, a variety of herbal remedies evolved for the treatment of infections, but very few have been evaluated by controlled clinical trials.
One of the more famous herbally derived therapies is quinine, which was used to treat malaria. It was originally isolated from the bark of the cinchona tree, which is native to South America. Today we use a synthetic form of quinine to treat the disease. Before that, cinchona bark was dried, ground into powder, and mixed with water for people to drink. The use of cinchona bark to treat fevers was described by Jesuit missionaries in the 1600s, though it was likely used in native populations much earlier.
An engraving of a Quinine plant, 1880.Wellcome Library, London, CC BY
Artemisinin, which was synthesized from the Artemisia annua plant is another effective malaria treatment. A Chinese scientist, Dr. Tu Youyou, and her team analyzed ancient Chinese medical texts and folk remedies, identifying extracts from Artemisia annua as effectively inhibiting the replication of the malaria parasite in animals. Tu Youyou was coawarded the 2015 Nobel Prize in Physiology or Medicine for the discovery of artemisinin.
The most potent naturally occurring honey is thought to be Manuka honey. It is derived from the flower of the tea tree bush, which has additional antibacterial properties.
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How Zithromax Is Used As An Antibiotic
Violetta Shamilova, PharmD, is a board-licensed pharmacist. She is an assistant professor at the Touro College School of Health Sciences, and has worked at CVS pharmacy for five years. She completed the certified APhA Delivering Medication Therapy Management Services course.
Zithromax is a versatile antibiotic used to treat many types of infections, including skin infections, ear infections, respiratory infections, and sexually transmitted infections. It is available as a pill or injection.
Selection Criteria And Search Study
Inclusion criteria were journal articles reporting clinical studies on treatment of Covid-19 patients with antibiotics. Case reports, non-clinical studies, reports on coronavirus other than the severe acute respiratory syndrome coronavirus 2, and articles not mentioning the use of antibiotic in these patients were excluded from the review. Studies for which data about antibiotic treatment were too scarce were excluded. Research was limited to English-language articles relative to adults. Two sources of information were used in this review.
First, we searched on Google using the terms Covid-19 and antibiotic use and selected the first result: an article questioning the impact of antibiotic use in Covid-19 patients on antibiotic resistance . The author notes the creation of a website by Adam Roberts and Issra Bulgasim to report secondary infections, antibiotic chemotherapy and antibiotic resistance in the context of Covid-19 . As of April 30th, there were 27 reported articles on the website from peer-reviewed published literature. We included fourteen studies as per our including criteria.
Flow chart of the search.
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How Do You Diagnose Pneumonia
- Symptoms – a doctor will suspect pneumonia from asking about your symptoms and how you are feeling. They may also ask about your medical history and that of your family. They will be interested in whether you smoke, how much and for how long. The examination may include checking your temperature. Sometimes your doctor will check how much oxygen is circulating around your body. This is done with a small device that sits on the end of your finger. The doctor will listen to your chest, so they may want you to lift or take off your top. If you want a chaperone during the examination, the doctor will arrange one. If you have asthma, they may ask you to check your peak flow measurement. They will listen to your chest with a stethoscope. Tapping your chest over the infected lung is also sometimes performed. This is called percussion. An area of infected lung may sound dull.
- X-ray – a chest X-ray may be required to confirm the diagnosis and to see how serious the infection is.
- Other tests – these tests are usually carried out if you need to be admitted to hospital. They include sending a sample of phlegm for analysis and blood cultures to check if the infection has spread to your blood.
Is Walking Pneumonia Contagious If So How Is It Spread And Who Is Most At Risk
Yes, walking pneumonia caused by Mycoplasma pneumoniae is contagious . When an infected person coughs or sneezes, tiny droplets containing the bacteria become airborne and can be inhaled by others who are nearby.
The infection can be easily spread in crowded or shared living spaces such as homes, schools, dormitories and nursing homes. It tends to affect younger adults and school-aged children more than older adults.
The risk of getting more severe pneumonia is even higher among those who have existing respiratory conditions such as:
The symptoms of walking pneumonia may come on slowly, beginning one to four weeks after exposure. During the later stages of the illness, symptoms may worsen, the fever may become higher, and coughing may bring up discolored phlegm .
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Blood Leeches And Knives
Bloodletting was used as a medical therapy for over 3,000 years. It originated in Egypt in 1000 B.C. and was used until the middle of the 20th century.
Medical texts from antiquity all the way up until 1940s recommend bloodletting for a wide variety of conditions, but particularly for infections. As late as 1942, William Osler s 14th edition of Principles and Practice of Medicine, historically the preeminent textbook of internal medicine, included bloodletting as a treatment for pneumonia.
Bloodletting is based on an ancient medical theory that the four bodily fluids, or humors , must remain in balance to preserve health. Infections were thought to be caused by an excess of blood, so blood was removed from the afflicted patient. One method was to make an incision in a vein or artery, but it was not the only one. Cupping was another common method, in which heated glass cups were placed on the skin, creating a vacuum, breaking small blood vessels and resulting in large areas of bleeding under the skin. Most infamously, leeches were also used as a variant of bloodletting.
A man sitting in chair, arms outstretched, streams of blood pouring out as a nun places leeches on his body.Images from the History of Medicine
Organisms Causing Bacterial Pneumonia In Dogs
Variable bacterial isolates have been reported in cases of bronchopneumonia in small animals. Most dogs with bacterial pneumonia are infected with a single organism, but some may have multiple isolates. In dogs, the majority of bacteria cultured in pneumonia are gram negative aerobic rods such as E. coli, Pseudomonas spp, Klebsiella spp, Enterobacter spp, Pasteurella spp, and Bordetella bronchiseptica. A minority of pneumonia cases culture positive for gram positive aerobic cocci such as Enterococcus spp, Streptococcus spp, and occasionally Staphylococcus spp. The incidence of anaerobic infections in dogs with bronchopneumonia is unclear, but may be up to 20%.
Except in acute, low-grade infections, representative cultures should be obtained from the respiratory tract prior to initiation of antibiotic therapy. Cultures may be obtained by transtracheal or endotracheal tube washes, by bronchoalveolar lavage, or by fine needle aspiration of consolidated areas of lung. Antimicrobial therapy should be initiated immediately after obtaining the tracheal wash for culture, and can then be fine-tuned once the result is obtained. This author has found that tracheal cultures are usually positive and useful even if the animal has received one or two doses of antibiotics.
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Choosing The Right Antibiotic
Dozens of antibiotics are available for treating pneumonia, but selecting the best drug is sometimes difficult. People with pneumonia need an antibiotic that is effective against the organism causing the disease. When the organism is unknown, “empiric therapy” is given, meaning the doctor chooses which antibiotic is likely to work based on factors such as the person’s age, health, and severity of the illness.
In adults, the choice of antibiotic therapy depends on the severity of infection and site of care. In all cases, the more quickly antibiotic therapy is started once the diagnosis is made, the better the outcomes. In most cases, the organism causing the pneumonia will not be known before antibiotic therapy is started, so the doctor must choose an antibiotic regimen based on history and symptoms. Later, the therapy may be altered when more information becomes available. To determine the appropriate antibiotic, the doctor must first answer a number of questions:
Once an antibiotic has been chosen, there are still difficulties:
- Individuals respond differently to the same antibiotic, depending on their age, health, size, and other factors.
- People can be allergic to certain antibiotics, thus requiring alternatives.
- People may have strains of bacteria that are resistant to certain antibiotics.
Coinfections Secondary Infections Rate And Timing And Impact On Survival
Eight studies recorded the occurrence of secondary infections and 2 reported co-infection rates. Pooled secondary and co-infection rate was 7.6% . Among studies reporting secondary infections, only one did not report frequency of these infections . Compiled results showed that 17.6% of patients who received antibiotics had secondary or co-infections. Interestingly, Zhou et al. noted that mean time until occurrence of secondary infections was 17 days after diagnosis for non survivors and 14 days for survivors who developed a secondary infection. He et al. reported that use of combination antibiotics was a significant predictor of nosocomial infection after adjustment for other covariates . Moreover, death rate was 15.4 % for patients who had secondary infections versus 7.3% in patients without secondary infections . Wang et al. noted there were significantly more coinfections in non-survivors than in survivors. Similarly, Zhou et al. reported that 50% of deaths in their cohort were imputable to secondary infections.
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Why Is This Medication Prescribed
Clarithromycin is used to treat certain bacterial infections, such as pneumonia , bronchitis , and infections of the ears, sinuses, skin, and throat. It also is used to treat and prevent disseminated Mycobacterium avium complex infection . It is used in combination with other medications to eliminate H. pylori, a bacterium that causes ulcers. Clarithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria.
Antibiotics such as clarithromycin will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
Key Points About Pneumonia
Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi.
There are more than 30 different causes of pneumonia, and theyre grouped by the cause. The main types of pneumonia are bacterial, viral, and mycoplasma pneumonia.
A cough that produces green, yellow, or bloody mucus is the most common symptom of pneumonia. Other symptoms include fever, shaking chills, shortness of breath, low energy, and extreme tiredness.
Pneumonia can often be diagnosed with a thorough history and physical exam. Tests used to look at the lungs, blood tests, and tests done on the sputum you cough up may also be used.
Treatment depends on the type of pneumonia you have. Antibiotics are used for bacterial pneumonia. It may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias dont have a specific treatment and just get better on their own. Other treatment may include a healthy diet, more fluids, rest, oxygen therapy, and medicine for pain, cough, and fever control.
Most people with pneumonia respond well to treatment, but pneumonia can cause serious lung and infection problems. It can even be deadly.
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