Monday, October 3, 2022

What Is The Treatment For Pneumococcal Pneumonia

What Is The Best Way To Prevent Pneumococcal Disease

What is pneumonia?

The single best way to prevent this disease is to be vaccinated.

  • Children should be vaccinated with a pneumococcal conjugate vaccine at 2, 4, and 6 months. They also need another shot, or booster, at 12 to 15 months of age.
  • Adults 65 years and older should be vaccinated with the PCV13 vaccine and a pneumococcal polysaccharide vaccine .
  • Adults who are 19 to 64 years of age with certain health risks should be vaccinated. These risks include: diabetes, smoking, alcoholism, asthma, chronic heart, liver, lung or kidney disease, sickle cell disease, a spleen that doesn’t work, cancer or other diseases that affect the immune system. Talk to your doctor about which pneumococcal vaccines are right for you.

How The Bacteria Is Spread

S. pneumoniae enter the human body through the nose and mouth, and an infection can be spread in the same way as a cold or the flu. This can be through:

  • direct contact for example, when someone coughs or sneezes, tiny droplets of fluid that contain the bacteria are launched into the air and can be breathed in by others
  • indirect contact for example, if infected droplets of fluid are transferred from someone’s hand to a door handle, someone else who touches the handle may become infected with the bacteria if they then touch their nose or mouth

It’s important to emphasise that pneumococcal infections are far less contagious than a cold or flu. This is because most people’s immune systems are able to kill the bacteria before they have the opportunity to cause an infection.

Outbreaks of pneumococcal infections can sometimes occur in environments where there are many people who have poorly functioning immune systems, such as in children’s nurseries, care homes for the elderly and homeless shelters.

Pneumonia In The Elderly

Elderly patients with pneumonia may not exhibit typical symptoms or physical examination findings seen in younger adults, such as pleuritic chest pain, cough, fever, and leukocytosis. Signs and symptoms more frequently seen in older adults include falls, decreased appetite, or functional impairment. A change in mental status should prompt evaluation for an infectious cause., As with any adult, risk factors for atypical or drug-resistant pathogens should guide treatment. Elderly patients with history of stroke or known dysphagia are at an increased risk for aspiration pneumonia. Residents of nursing homes or long-term care facilities are at an increased risk for methicillin-resistant Staphylococcus aureus or multidrug-resistant pathogens.

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Treatment And Medication Options For Pneumonia

A lot of treatment aspects, as well as outcome, depend on the person, as well as the type of pneumonia they have, says Dr. Barron. Sometimes youll be fine just resting, but if you have things like trouble breathing, you should get to a doctor right away.

Your doctor will outline a plan that’s specific to you, considering the type of pneumonia you have, the severity of the condition, your age, and your overall health. From there, you’ll know whether you can be treated at home or need to go to the hospital, and whether you require antibiotics.

Causes And Risk Factors Of Pneumonia

How Is Pneumonia Treated and Prevented?

How do you get pneumonia? The majority of the germs that cause infection are spread from person to person through droplets, from coughing or sneezing.

People who smoke are at higher risk for pneumonia, as are people on immunosuppressive medications, and people who are frequently in close, crowded spaces with others, such as college students and military personnel.

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Treatment Of Pneumococcal Pneumonia

Pneumococcal pneumonia is generally treated with amoxycillin, ampicillin or co-amoxiclav.

For severe infections:

  • intravenous antibiotics e.g. ampicillin or co-amoxiclav. Oral amoxicillin or augmentin can be used when the pneumonia is resolving clinically and the patient is apyrexial.

For mild-moderate infections:

  • amoxicillin 500mg-1g tds for 10-14 days* PO
  • in patients allergic to penicillin, a suitable alternative is erythromycin 500mg qds PO or clarithromycin 500mg bd** PO

Alternative treatments in penicillin allergy include erythromycin or cefuroxime .

Prophylaxis:

Notes:

  • *BTS guidelines recommend adequate dosing of amoxicillin to cover intermediate-resistant strains of Strep pneumoniae
  • ** clarithromycin may be substituted for those with gastrointestinal intolerance to oral erythromycin and also has benefit of twice daily dosage

Reference:

  • Drugs and Therapeutics Bulletin , 36 , 65-72.
  • Last reviewed 01/2018

    What Are The Complications

    • Pneumonia: Many people in the U.S. who get pneumococcal pneumonia need to be cared for in the hospital. About 5 to 7% of people with this type of pneumonia will die. The elderly have a higher risk of death.
    • Blood infections: As many as 20% of people who get a blood infection from this disease die. The death rate may be as high as 60% for the elderly.
    • Bacterial meningitis: Pneumococcal meningitis infections cause more than 50% of all bacterial meningitis cases in the U.S. About 8% of children and 22% of adults with pneumococcal meningitis will die.
    • Middle ear infections. This is the most common reason for visits to a pediatrician in the U.S. Complications of these ear infections can lead to meningitis. It can also cause infection in a bone behind the ear.

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    When To Seek Emergency Medical Advice

    The most serious type of pneumococcal infection is bacterial meningitis, which requires immediate admission to hospital for emergency treatment.

    Bacterial meningitis has a number of early warning signs that can occur earlier than the other symptoms.

    These are:

    • pain in the muscles, joints or limbs such as in the legs or hands
    • shivering or unusually cold hands and feet
    • blue lips and pale or blotchy skin

    Treatment Of Specific Infections

    Understanding Pneumococcal Pneumonia

    Otitis media

    The guideline produced by the American Academies of Pediatrics and Family Practitioners for the treatment of pneumococcal otitis media recommends first-line treatment of most patients with amoxicillin 80-90 mg/kg/day or amoxicillin-clavulanate . Alternatives include cefdinir, cefuroxime, cefpodoxime, or ceftriaxone. These alternative antibiotics vary in their efficacy against the different pathogens known to cause otitis media. US data on in vitro susceptibility of S pneumoniae to cefdinir and cefuroxime are 70% to 80%, respectively, compared with 84% to 92% to amoxicillin.

    Patients who do not improve within 48-72 hours should be re-evaluated and their antibiotics switched to amoxicillin-clavulanate or a second- or third-generation oral cephalosporin, although highly resistant pneumococci may require treatment with parenteral ceftriaxone in order to achieve adequate serum levels of antibiotics.

    Sinusitis

    The typical pathogens that cause sinusitis mimic those of otitis media therefore, initial therapeutic recommendations are similar. In adult allergic patients and in adults who do not respond to initial therapy, fluoroquinolones provide appropriate coverage. In this clinical situation, this class of antibiotics is not approved for children.

    Pneumonia

    Meningitis

    The recommendations for treatment of bacterial meningitis in adults are similar to those in children.

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    Pneumococcal Vaccine For Adults

    Adults can have the pneumococcal vaccine or “pneumo jab” for free if they’re in a high-risk group for developing a pneumococcal infection.

    If you think you could be eligible for the pneumococcal vaccine, speak to your GP or practice nurse to arrange an appointment.

    Healthy adults usually only need one dose of the pneumo jab. However, if you’ve a weakened immune system or spleen disorder, you may need additional booster doses. Your GP can advise you about this.

    After you’ve had the pneumo jab, you may experience some pain and inflammation at the site of the injection. This should last no longer than three days. Less commonly, some people report the symptoms of a mild fever. Again, this should pass quickly.

    Read more about potential side effects of the pneumococcal vaccine.

    Diagnosis Of Pneumococcal Disease

    Since other types of bacteria can cause similar infections, it is important to test specifically for the presence of Streptococcus pneumoniae. Depending on the symptoms, pneumococcal disease is diagnosed using a number of tests, including:

    • physical examination
    • hospital admission in severe cases for example, meningitis.

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    Risk Of Pneumococcal Disease

    Certain groups are at increased risk of infection, including:

    • children aged under two years
    • children under five years with underlying medical conditions predisposing them to invasive pneumococcal disease
    • Aboriginal and Torres Strait Islander children, especially in central Australia
    • Aboriginal and Torres Strait Islander people
    • people aged 65 years and over
    • people with weakened immune systems
    • people with chronic diseases such as diabetes, lung disease, cancer or kidney disease
    • people who have impaired spleen function or have had their spleen removed
    • people who smoke tobacco.

    What Should I Or My Family Members Do If We Travel Out Of The Country

    Bronchopneumonia: Symptoms, causes, and treatment
    • Pneumococcal disease occurs around the world. It is more common in developing countries. You may be at higher risk if you spend time in crowded settings or come in close contact with children in countries where pneumococcal vaccine is not routinely used. Make sure that you are vaccinated according to the recommendations above.
    • Wash your hands often with soap and water. If soap and water aren’t available, use hand sanitizer. Avoid touching your eyes, nose or mouth. Cover your mouth when you cough or sneeze. Also, avoid close contact and sharing cups or eating utensils with people who are sick.

    Travel and pneumococcal disease:

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    Is Pneumonia Curable

    A variety of infectious agents cause pneumonia. With proper recognition and treatment, many cases of pneumonia can be cleared without complications.

    For bacterial infections, stopping your antibiotics early can cause the infection to not clear completely. This means your pneumonia could come back.

    Stopping antibiotics early can also contribute to antibiotic resistance. Antibiotic-resistant infections are more difficult to treat.

    Viral pneumonia often resolves in 1 to 3 weeks with at-home treatment. In some cases, you may need antivirals.

    Antifungal medications treat fungal pneumonia. It may require a longer period of treatment.

    What To Think About

    Medicines, such as penicillin, used to work well for the treatment of pneumonia and meningitis. These diseases have recently become resistant to these medicines. For this reason it is important to try to prevent the infections by having the PCV or PPV vaccine.

    PCV can prevent some ear infections. But ear infections have many causes and PCV only works to prevent some of them. Your child may still have ear infections, even after getting a PCV shot.

    PPV has not been studied in pregnant women. There is no evidence that the vaccine is harmful to either the mother or the baby. Pregnant women should talk with a doctor about getting the medicine. Women who are at high risk of pneumococcal disease should have the shot before becoming pregnant, if possible.

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    Favorite Orgs That Can Help Fight Pneumonia

    Those over age 65 have a higher risk of getting pneumonia than younger adults. They may be especially susceptible to community-acquired pneumonia, spread among large populations of elderly people in settings such as assisted living facilities. This organization, devoted to finding the best products and services for seniors, publishes advice on how older adults should handle prevention and care.

    Influenza is a common cause of pneumonia. Several national healthcare organizations and the CDC are collaborating in an effort called United Against the Flu to stress the importance of getting immunized. The groups website supplies resources and details on the vaccination.

    What Is The Best Treatment

    What Is Pneumonia?
    Otitis media

    For treatment of otitis media in children, amoxicillin, 30mg/kg, three times daily, is recommended, based on the following reasoning:

    • S. pneumoniae is the most common identifiable cause of otitis and the one associated with the greatest morbidity.

      Continue Reading

    • Penicillin-susceptible and intermediately resistant pneumococci are likely to respond better to this treatment than to any other.

    • No other oral therapy is likely to be more effective for resistant pneumococci.

    Because of the high rate of spontaneous resolution, the American Academy of Pediatrics has subsequently recommended watchful waiting for children aged greater than 2 years unless severe pain or high fever are present, and these recommendations seem appropriate for adults, as well. When adults are treated, amoxicillin should be given at 500mg four times daily. If this treatment fails, amoxicillin/clavulanic acid, a fluoroquinolone or ceftriaxone can be used. In the absence of a perforated tympanic membrane or some other complication, therapy need not be continued beyond 5 days.

    Sinusitis
    Pneumonia, outpatients
    Pneumonia, inpatients
    Meningitis
    Nonantibiotic adjunctive therapy
    Are there issues of anti-infective resistance?

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    Pneumococcal Disease Vaccine For Children

    The risk of infection in young children, especially those under two years of age, can be substantially reduced with a vaccine called Prevenar 13. Under the National Immunisation Program Schedule, this vaccine is free for all infants at two, four and 12 months of age. Extra pneumococcal vaccine is given to children with certain medical risk factors at six months and four to five years of age.

    Pneumococcal Vaccine For Babies

    All babies are offered pneumococcal immunisation as part of the NHS childhood immunisation schedule.

    They’ve 3 doses, which are given:

    • at 8 weeks
    • at 16 weeks
    • between 12 and 13 months of age

    The pneumococcal vaccine for babies is entirely safe, although around one baby in 10 will have some redness and swelling at the site of the injection, and symptoms of a mild fever. However, these side effects will pass quickly.

    Speak to your GP or health visitor if you are not sure whether your child has received their pneumococcal immunisation.

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    Urgent Advice: Contact Your Gp Or If Your Gp’s Closed Phone 111 If:

    • you have a constant high temperature that lasts for more than three days
    • you cough up mucus streaked with blood
    • you develop rapid breathing or chest pains
    • you become drowsy or confused
    • you experience shortness of breath or other breathing difficulties
    • your child is under three months and has a temperature of 38C or above
    • your child is over 3 months and has a temperature of 39C or above
    • your child is over two years of age and their symptoms persist for more than three days

    You should also contact your GP if you have any of the risk factors that make you more vulnerable to developing a pneumococcal infection.

    Read about the causes of pneumococcal infections for more information about these risk factors.

    How Pneumococcal Infection Is Spread

    Bacterial Pneumonia in People with COPD

    Pneumococcal infection is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges. Pneumococcal infections are more common during the winter and may be triggered by viral infections.

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    How Is Pneumonia Diagnosed

    Its a tough disease to diagnose, says , a pulmonologist and the medical director of the lung transplant program at the Cleveland Clinic in Ohio. Age makes a big difference, as well as a persons immune status and, of course, the symptoms themselves. Pneumonia symptoms often mimic those of the common cold and the flu, as well as acute bronchitis, an inflammation of the lining of your bronchial tubes .

    How Is Pneumonia Treated

    When you get a pneumonia diagnosis, your doctor will work with you to develop a treatment plan. Treatment for pneumonia depends on the type of pneumonia you have, how sick you are feeling, your age, and whether you have other health conditions. The goals of treatment are to cure the infection and prevent complications. It is important to follow your treatment plan carefully until you are fully recovered.

    Take any medications as prescribed by your doctor. If your pneumonia is caused by bacteria, you will be given an antibiotic. It is important to take all the antibiotic until it is gone, even though you will probably start to feel better in a couple of days. If you stop, you risk having the infection come back, and you increase the chances that the germs will be resistant to treatment in the future.

    Typical antibiotics do not work against viruses. If you have viral pneumonia, your doctor may prescribe an antiviral medication to treat it. Sometimes, though, symptom management and rest are all that is needed.

    Most people can manage their symptoms such as fever and cough at home by following these steps:

    If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids and antibiotics, as well as oxygen therapy, and possibly other breathing treatments.

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    What Is Pneumococcal Pneumonia

    Simply put, itâs an infectious, potentially serious bacterial lung disease. The symptoms can hit without warning and can take you out of your routine for weeks. It could even put you in the hospital.

    Did you know there is more than one type of pneumonia? Although pneumonia always means an infection of the lungs, there are actually many different types. Two of the most common types are viral and bacterial.

    The most common type of bacterial pneumonia is called pneumococcal pneumonia.

    Pneumococcal pneumonia can be serious. Symptoms can come on quickly, and can include cough, fatigue, high fever, shaking chills, and chest pain with difficulty breathing. Some symptoms can last weeks or longer.

    In severe cases, pneumococcal pneumonia can lead to hospitalization. Or in some cases, even death.

    Pneumococcal pneumonia is not a cold or the flu. It is a bacterial lung disease, while the flu and cold are caused by viruses.

    In some cases, pneumococcal pneumonia can cause part of your lung to fill up with mucus, making it hard to breathe.

    You can catch pneumococcal pneumonia through coughing or close contact. It can strike anywhere, anytimeâand may hit quickly and without warning.

    Itâs not just old and unhealthy people who are at risk for pneumococcal pneumonia. If you are 65 or older, you may be at increased risk for pneumococcal pneumonia, even if you are otherwise healthy. Thatâs because as you get older, your immune system becomes less able to respond to infections.

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