Keywords: bacterial pneumonia
Antimicrobial treatment is the key to determine the prognosis of bacterial pneumonia. Common pathogens of acute pneumonia and commonly used drug selection program, listed in Table 1 for reference.
2 to 3 days after the anti-infection treatment, the condition does not improve or deteriorate, anti-infective drugs should be reversed. The existing pathogenic check results sensitive to the drug should be selected based on susceptibility testing. Etiological information to follow, you should re-examine the possibility of pneumonia pathogen, a new round of empirical treatment. Total treatment of mild to moderate pneumonia at the control of symptoms such as body temperature to normal after the end of the 3 to 7 days; serious condition for 1 to 2 weeks; Staphylococcus aureus pneumonia in immunosuppressed patients with pneumonia, treatment should be appropriately extended; inhaled pneumonia or lung abscess, the total course be several weeks to a few months.
Other treatment should be based on the condition chosen, such as oxygen, cough and phlegm, infusion with anti-shock.
A general treatment:
Bed rest, into digestible rich protein, electrolytes, vitamins, food, pay attention to moisture supplement. Fever were given physical cooling necessary to antipyretic drugs. The severe chest can I Fenbid the 0.3g orally 2 times / day, or codeine tablets 15mg oral. Cough to severe cough will clear 25mg or withdrawal cough 100mg orally 3 times / day, if necessary, with codeine.
Second, to promote expectoration:
Encourage patients to cough, turn over, or to promote expectoration shoot back. To saline 10ml plus α – chymotrypsin 5mg expectorant and antispasmodic drugs, if necessary, dexamethasone 5mg and low levels of antibiotics, inhalation 2 times / d.
Third, the application of antibiotics:
Pathogens is not clear, the medication may experience.
(A) Gram-positive cocci, penicillin, cefazolin, erythromycin, cotrimoxazole. Gram-negative bacteria or mixed infections cefazolin, amoxicillin, cefuroxime available. Serious condition selected third-generation cephalosporin, b-lactam + aminoglycoside and cotrimoxazole.
(B) of nosocomial infection: mild, moderate available piperacillin, head cell azole Linga gentamicin, head cellular furosemide Xin, head the intracellular hydroxyl azole or cefotaxime, head cell ceftizoxime, ciprofloxacin, ofloxacin, etc., can also be used Unasyn enzyme inhibitors (β-lactam antibiotics). Have history of aspiration, or thoracoabdominal major surgery, should be added with of A consumer azole or clindamycin. S. aureus infection can be oxacillin, nafcillin or vancomycin resistance. Long-term use of hormones, antibiotics by application of the third generation cephalosporins, imipenem, and ciprofloxacin plus aminoglycoside antibiotics. Concurrent fungal infection plus fluconazole. Pathogens identified, should be adjusted based on the results of susceptibility testing of sputum culture antibacterial drugs.
Immunomodulatory agents such as immunoglobulin, transfer factor, thymosin adjuvant therapy will definitely help, Pseudomonas aeruginosa antiserum endotoxin antibodies is still in the test stage.
Fifth, the treatment of complications:
With respiratory failure given oxygen therapy and respiratory support. Electrolyte imbalance, liver and kidney dysfunction treated accordingly. Empyema drainage or surgical treatment.