Everything You Need to Know About Treating Pneumonia

December 28, 2018
Pneumonia treatment consists in administrating different antibiotics according the type of pneumonia that's afflicting the patient

The types of pneumonia can be divided into two main categories:

  • Community-acquired pneumonia. Patients can contract community-acquired pneumonia in their everyday settings.
  • Hospital-acquired pneumonia. This type of pneumonia refers to patients who contract pneumonia while being hospitalized. These cases tend to be more serious, as it’s not the patient’s only affliction that requires treatment. In other words, it becomes an additional problem. These tend to be bacterial infections that are present in the hospital. They tend to be quite resistant in people who are sick or recuperating from other illnesses. For that reason, hospital-acquired pneumonia cases are more difficult to treat.

All kinds of pneumonia can lead to sepsis, which is when the infection spreads into the bloodstream. If the case escalates to sepsis, pneumonia could lead elderly patients, or patients with weakened immune systems, to death. The risk makes it very important to establish a treatment according to each case by attending to its particular needs.

While various treatments are available for the different groups of patients, we shouldn’t rush to conclusions and resort to generalizations.

The most appropriate person to determine the best treatment for a patient is a doctor. 

What causes pneumonia?

Pneumonia can result from a bacterial, viral or fungal infection. According to the cause or etiology, doctors can determine a treatment or other alternative.

In order to understand the treatments, let’s review the 3 causes of this pathology:

Also see: Symptoms of Pneumonia and Remedies

Viral pneumonia

Viral pneumonia

The most obvious example of this kind of pneumonia is when it results from a virus such as the flu or chickenpox. 

Bacterial pneumonia

This includes:

  • Pneumococcal
  • Staphylococcus
  • Gram-negative bacilli (-)
    • Haemophilus influenzae
    • Klebsiella pneumoniae
    • Escherichia coli
    • Pseudomonas aeruginosa

In the bacterial group, there also atypical types of pneumonia. Atypical types of pneumonia evolve slower than normal cases. They aren’t easily spotted in clinical pictures and the pneumonia-causing agents tend to be less common.

The bacteria that cause atypical pneumonia are the following: Legionella pneumophila, Mycoplasma pneumoniae, Clamydia pneumoniae.

Fungal pneumonia

This kind of pneumonia results from fungal organisms such as Candida, or Pneumocystis jiroveci. This type of pneumonia is more common in patients with weakened immune systems. For example, this may be patients with HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome).

Pneumonia treatment

Generally speaking, pneumonia treatment consists in administrating antibiotics to the patient. Depending on what caused the infection, its characteristics and the overall state of health of the patient, doctors prescribe a certain antibiotic or can opt for a combination of several.

B are the types of treatments available according to the etiology.

Pneumococcal pneumonia

The most common pneumonia in this group is the Streptococcus pneumoniaeTo treat this case, doctors administer amoxicillin. However, there is a high chance of resistance to this antibiotic.

If the body shows resistance, the treatment can include other kinds of medication:

  • Cephalosporins
  • Clindamycin
  • Cefuroxime
  • Erythromycin (in cases of more serious infections)

There’s also a vaccine available for streptococcal pneumonia. It’s aimed towards children and people older than 50. However, it doesn’t prevent pneumonia that results from other causative agents, such as the ones listed above.

Staphylococcus pneumonia

Among these types of pneumonia cases, the main cause is Staphylococcus aureusThe treatment for this kind of pneumonia calls for penicillinase.

Among the types of penicillinase available are:

  • Flucloxacillin. This medication counter-reacts the microorganism’s beta-lactamase (penicillinase).
  • Cephalosporins including cefalotin and cefamandole.
  • Clindamycin. Effective against 90% of bacterial strains.

Gram-negative bacilli pneumonia

Gram-negative bacilli pneumonia

In the Gram-negative group, the main causes of pneumonia are the following:

  1. Haemophilus influenzae.
  2. Klebsiella pneumoniae.
  3. Escherichia coli.
  4. Pseudomonas aeruginosa.

The corresponding treatments for each one are:

  1. Haemophilus influenzae. There is a vaccine available for Haemophilus influenzaetipo b. As a preventative measure, all children are advised to get the vaccine. The drug of choice is cotrimoxazole, which is an antibiotic that combines trimethoprim and sulfamethoxazole. Other antibiotics are: cephalosporins for Gram-negative, amoxicillin, fluoroquinolones and azithromycin.
  2. Klebsiella pneumoniae. This bacteria is resistant to ampicillin as well as to a number of beta-lactamase. However, it’s very susceptible to aminoglycosides and cephalosporins antibiotics.
  3. Escherichia coli. Pneumonia treatment that targets this bacteria requires the patient’s hospitalization for respiratory support. The support can provide them with sufficient oxygen. In these kinds of cases, doctors opt to administer fluoroquinolones and cephalosporins such as cefixime, cefpodoxime, ceftibuten and cefdinir.
  4. Pseudomonas aeruginosa. In order to establish an effective treatment for these cases, doctors need a biopsy and must base treatment off of the results. This bacteria is resistant to numerous types of antibiotics.

Atypical pneumonia treatment

Legionella pneumophila pneumonia

  • The drug of choice that fights Legionella is erythromycin.
  • If the case is serious, rifampin might completment erythromycin.
  • Other options might be ciprofloxacino, azithromycin or other medications chosen by medical specialists.

Mycoplasma pneumoniae pneumonia

Most patients infected by this bacteria can overcome the infection with or without treatment. In cases of the former, the antibiotic of choice is erythromycin.

However, treatments might also use the following:

  • Tetracycline
  • Clarithromycin
  • Azithromycin

Clamydia pneumoniae pneumonia

This bacteria usually leads to cases serious enough to require hospitalization. Treatments usually entail the administration of doxycycline, excluding cases of patients with chronic illnesses linked to heart attacks or other problems.

Other frequently used drugs in these kinds of infection cases are erythromycin and Tetracycline. Treatment usually lasts for a period of 10 to 21 days.

Viral pneumonia treatment

Treating Pneumonia

When the pneumonia treatment results form a virus, antivirals like acyclovir are recommendable for treating the lung infections that derive from herpes simplex, herpes zoster or chicken pox.

Pneumonia caused by cytomegalovirus (CMV) can be treated with ganciclovir. However, it hasn’t shown to be effective for treating patients with AIDS.

Some patients develop posterior bacterial infections that require them to undergo an antibiotic treatment. If a patient has a viral infection, it’s recommendable that they take fever-reducing, pain and cough medicine.

Also read: Symptoms of Pneumonia and Remedies

Fungal pneumonia treatment

In this case, doctors administer antifungal medication:

  • Amphotericin B
  • Fluconazole
  • Itraconazole
  • Flucytosine

These drugs may lead to adverse effects. Users should notify their doctor should they experience any of the following:

  • Increasing sensitivity to the sun (especially the eyes)
  • Fever
  • Chills
  • Skin rash
  • Itching
  • Diarrhea
  • Nausea
  • Vomiting