To the elderly, systemic immune function and respiratory insufficiency; old patient suffering from chronic bronchitis, tuberculosis, emphysema, diabetes are prone to respiratory infections, including pneumonia in the elderly over the age of 65 causes of death in the first place.
Many elderly people with a variety of diseases, pneumonia and often involving multiple organs, there will be the so-called domino phenomenon, as well as non-medical treatment. Therefore, we should pay attention to the serious harm of elderly people suffering from pneumonia.
The elderly pneumonia has several distinctive features: First, the incidence of covert. The lower the body’s ability to respond for the elderly, sometimes lung disease, but fever is not obvious, the body temperature more than 37.5 ℃ -38.5 ℃, cough is not severe, difficult to expectorate sputum, chest pain, mild, white blood cells is not increased even low or just a neutrophil high, often need the help of X-ray inspection can be confirmed.
Secondly, pneumonia, Gram-positive cocci, common pathogens, but the elderly with underlying diseases or recurrent infections, Gram-negative bacilli infections significantly increased risk. Therefore, medication for Gram-positive cocci, but must take into account the gram-negative bacilli.
If they previously healthy, there is no underlying disease and mild infection, optional penicillin drugs intravenously, the total daily dose of the medication should be divided into 3-4 doses. Accompanied by the light of the underlying disease, moderate infections in elderly patients, the increased level of general infection, increased risk of infection rates by Gram-negative bacilli may consider to select the semi-synthetic penicillin with beta-lactamase inhibitors, second-generation cephalosporins cephalosporins, quinolones. Severe pneumonia accompanied by a variety of underlying diseases, should be timely with broad spectrum antibiotics.
Third, the elderly aspiration pneumonia, fungal pneumonia more often repeated infections.
The swallowing reflex dysfunction, dysphagia, airway clearance dysfunction and other factors, significantly higher incidence of aspiration pneumonia in the elderly. The treatment of choice for 3rd generation cephalosporin with metronidazole or tinidazole. Immune dysfunction, and some elderly people used a variety of antibiotics, it is prone to the flora and secondary infection, but also the common pulmonary fungal infections. Best joint use of fluconazole, the use of antibiotics to prevent superinfection. Repeated infections of the elderly, but also pay attention to the recent use of antibiotics in the same class of antibiotics recently reuse easily lead to drug resistance.
Finally, the elderly pneumococcal vaccination and influenza vaccine effective in preventing pneumonia. The pneumococcal polysaccharide Phytophthora bacteria (PPV) can resist the attack of the 23 kinds of pneumococcus. Extensive vaccination for influenza vaccine also makes influenza meningitis incidence decreased, the effective rate of 53% to prevent pneumonia.