Materiały źródłowe

• #1 Pneumonia Treatment and Recovery | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/treatment-and-recovery

  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.

• #1 Bacterial Pneumonia Treatment & Management: Approach Considerations, Antimicrobial Therapy for Bacterial Pneumonia, Outpatient Empiric Antibiotic Therapy

  https://emedicine.medscape.com/article/300157-treatment

  The goals of pharmacotherapy for bacteria pneumonia are to eradicate the infection, reduce morbidity, and prevent complications. […] Treatment of pneumonia depends largely on the empiric use of antibiotic regimens directed against potential pathogens as determined by the setting in which the infection took place and the potential for exposure to multidrug-resistant (MDR) organisms and other more virulent pathogens (ie, community-acquired pneumonia [CAP], healthcare-acquired pneumonia [HCAP], hospital-acquired pneumonia [HAP], ventilator-associated pneumonia [VAP]). […] The prevalence and resistance patterns of MDR pathogens vary between institutions and even between ICUs within the same institution. Therefore, appropriate initial antibiotic therapy for HAP and VAP may vary markedly according to hospital site. Antimicrobial prescribing practices should not necessarily be based on national guidelines, but rather on patterns of MDR organisms at individual institutions.

• #1 Guidelines for the Evaluation and Treatment of Pneumonia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7112285/

  Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. […] Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia. […] Pneumonia is a common respiratory infection and warrants careful consideration of antibiotic initiation and choice, along with knowledge of local antibiotic resistance patterns. […] Pediatric pneumonia is also common, and first-line treatment is still amoxicillin, followed closely by cephalosporins or macrolides. […] When available, treatment of CAP should be guided by local resistance patterns. In previously healthy patients who are appropriate for outpatient treatment, recommended first-line treatment is with a macrolide antibiotic such as azithromycin targeting the most common causal pathogen S. pneumoniae.

• #1 Diagnosis and Treatment of Community-Acquired Pneumonia | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0201/p442.html

  Patients with community-acquired pneumonia often present with cough, fever, chills, fatigue, dyspnea, rigors, and pleuritic chest pain. […] Consensus guidelines from several organizations recommend empiric therapy with macrolides, fluoroquinolones, or doxycycline. […] The initial treatment of CAP is empiric, and macrolides or doxycycline (Vibramycin) should be used in most patients. […] The primary goals of pharmacotherapy for patients with CAP include eradicating the causative pathogens, resolving the clinical signs and symptoms, minimizing hospitalization, and preventing reinfection. […] Consensus guidelines from ATS, Infectious Diseases Society of America, and Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia recommend initial empiric therapy with macrolides, fluoroquinolones, or doxycycline (Vibramycin).

• #1 Antibiotics for Pneumonia: What is the Best Treatment? – K Health

  https://www.khealth.com/learn/antibiotics/antibiotics-for-pneumonia/

  When a person contracts pneumonia, the air sacs in one or both lungs, called alveoli, fill with pus or fluid. […] Pneumonia is typically caused by viruses or bacteria. […] Antibiotics won’t help with viral pneumonia. […] If your doctor suspects that you have bacterial pneumonia, they will treat you with antibiotics. […] If you have bacterial pneumonia, you will need antibiotics to prevent complications and to help your body clear the infection. […] Most bacterial pneumonia that is community-acquired (meaning you do not get it while you are in the hospital) comes from the bacteria Streptococcus pneumoniae. […] Azithromycin is a first-line treatment for healthy adults under age 65 with bacterial pneumonia. […] Clarithromycin is another macrolide antibiotic that is commonly used for pneumonia.

• #1 The Medical Letter Home Page | The Medical Letter, Inc.

  https://secure.medicalletter.org/TML-article-1616b

  Treatment of community-acquired pneumonia (CAP) is usually empiric, with selected antibiotic regimens directed against some of the most common causative pathogens. Recommended empiric regimens are listed in Table 2; recommended antibiotic dosages for treatment of CAP are listed in Tables 3 and 4. Joint guidelines for treatment of CAP by the American Thoracic Society and the Infectious Diseases Society of America (ATS/IDSA) were updated in 2019.1 […] For outpatient treatment of CAP in otherwise healthy adults without comorbidities (chronic heart, lung, liver or renal disease, diabetes, alcoholism, malignancy, or asplenia), current guidelines recommend oral treatment with high-dose amoxicillin (1 g tid) or doxycycline (see Table 2). […] For outpatient treatment of CAP in adults with comorbidities (chronic heart, lung, liver or renal disease, diabetes, alcoholism, malignancy, or asplenia), oral treatment with a combination of a beta-lactam (amoxicillin/clavulanate, cefpodoxime, or cefuroxime) and a macrolide (azithromycin, clarithromycin) or doxycycline is recommended.

• #1 Guidelines for the Evaluation and Treatment of Pneumonia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7112285/

  Patients with comorbidities such as diabetes; chronic heart, lung, renal, or liver disease; alcoholism; asplenia; impaired immune system; or recent antibiotic use within the last 3 months have an increased risk for drug-resistant S pneumoniae. As such, a respiratory fluoroquinolone or -lactam plus a macrolide is recommended. […] Patients should be treated for a minimum of 5 days and should be clinically stable with resolving symptoms before treatment is discontinued. […] In recent years, there has been emerging data supporting the use of adjunctive corticosteroids in the inpatient treatment of CAP. […] A Cochrane 2017 meta-analysis in the primary care setting concluded that the use of procalcitonin to guide initiation and duration of antibiotic treatment results in lower risks of mortality, lower antibiotic consumption, and lower risk for antibiotic-related side effects.

• #1 Community-Acquired Pneumonia in Adults: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/1101/p698.html

  Administration of corticosteroids within 36 hours of hospital admission for patients with severe community-acquired pneumonia decreases the risk of adult respiratory distress syndrome and length of treatment. […] For patients with severe community-acquired pneumonia, corticosteroids decrease the risk of adult respiratory distress syndrome and modestly reduce intensive care unit and hospital stays, duration of intravenous antibiotic treatment, and time to clinical stability without increasing major adverse events. […] In patients with suspected CAP, chest radiography or lung ultrasonography should be performed to confirm the diagnosis. […] Patients with CAP who are admitted to the intensive care unit should be treated with dual antibiotic therapy. […] Given the relatively low yield of standard culture techniques, empiric treatment using the 2007 Infectious Diseases Society of America and American Thoracic Society guidelines targets likely pathogens based on epidemiologic risk factors.

• #1 The Medical Letter Home Page | The Medical Letter, Inc.

  https://secure.medicalletter.org/TML-article-1616b

  In patients who are hospitalized for nonsevere CAP, empiric treatment with a combination of an IV beta-lactam (ampicillin/sulbactam, ceftriaxone, cefotaxime, or ceftaroline) and an IV or oral macrolide (azithromycin, clarithromycin) or monotherapy with an IV or oral respiratory fluoroquinolone (levofloxacin, moxifloxacin) is recommended. […] In patients who are hospitalized for severe CAP and do not have risk factors for infection with P. aeruginosa (or other resistant gram-negative pathogens) or MRSA, empiric treatment with an IV beta-lactam (ampicillin/sulbactam, cefotaxime, ceftriaxone, or ceftaroline) plus either an IV macrolide (azithromycin) or an IV respiratory fluoroquinolone (levofloxacin, moxifloxacin) is recommended. […] Hospitalized patients with CAP who have risk factors for infection with MRSA or resistant gram-negative organisms such as P. aeruginosa may be treated empirically for such pathogens in addition to standard empiric treatment.

• #1 Community-acquired pneumonia: Strategies for triage and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/3/145

  Patients on a medical floor should be started on either a respiratory fluoroquinolone or a combination of a beta-lactam plus a macrolide; intensive care patients should receive a beta-lactam plus either a macrolide or a respiratory fluoroquinolone. […] If an organism is identified by culture, polymerase chain reaction, or serology, the empiric antibiotic regimen should be tailored to this organism. […] The use of adjunctive corticosteroids for CAP management has been widely contested. The IDSA/ATS guidelines recommend against corticosteroid use for adjunctive treatment of CAP except in patients with refractory septic shock. […] Antibiotics should be given for at least 5 days, though longer durations may be needed in immunocompromised patients or in those with pulmonary or extra-pulmonary complications.

• #1 Community-Acquired Pneumonia in Adults: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/1101/p698.html

  Outpatients with comorbidities or antibiotic use in past three months should receive a respiratory fluoroquinolone or a beta-lactam antibiotic plus a macrolide. […] Hospitalized patients who are not admitted to the ICU should receive a respiratory fluoroquinolone or a beta-lactam antibiotic and a macrolide. […] Patients with severe CAP who are admitted to the ICU should receive dual antibiotic therapy, which has been shown to improve survival. […] Meta-analyses of randomized trials of corticosteroids for CAP demonstrate a decreased risk of adult respiratory distress syndrome and modest reductions in lengths of ICU and hospital stays, duration of intravenous antibiotic treatment, and time to clinical stability without a corresponding increase in major adverse events.

• #1 Bacterial Pneumonia Treatment & Management: Approach Considerations, Antimicrobial Therapy for Bacterial Pneumonia, Outpatient Empiric Antibiotic Therapy

  https://emedicine.medscape.com/article/300157-treatment

  Antibiotic choices in the outpatient setting should be driven by the presence of patient risk factors, including recent exposure to antibiotics, comorbidities, and local trends in antibiotic resistance. […] For suspected infection with methicillin-resistant S aureus (MRSA), vancomycin or linezolid may be added to the antibiotic regimen until the organism’s identity and antibiotic sensitivities are known, at which point the medications can be adjusted accordingly. […] Supportive measures include the following: Analgesia and antipyretics, Chest physiotherapy, Intravenous fluids (and, conversely, diuretics) if indicated, Monitoring Pulse oximetry with or without cardiac monitoring, as indicated, Oxygen supplementation, Positioning of the patient to minimize aspiration risk, Respiratory therapy, including treatment with bronchodilators and, perhaps, N-acetylcysteine in selected patients.

• #1 Pneumonia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/pneumonia/

  Begin empiric antibiotic therapy based on severity and patient risk factors (e.g., VAP vs. CAP). […] Consider antiviral therapy for influenza and COVID-19 as indicated. […] Reevaluate therapy within 48 hours. […] Duration of treatment: 3 to 5 days of therapy is usually sufficient for CAP that is treated in the outpatient setting. […] Patients with comorbidities or risk factors for resistant pathogens should receive combination therapy. […] If aztreonam is used as an alternative to other -lactam antibiotics, additional coverage for MSSA must be included (e.g., a fluoroquinolone). […] Empiric antibiotic therapy should be narrowed and/or de-escalated as soon as feasible. […] Patients with structural lung disease and/or at high risk for mortality should receive double antipseudomonal coverage!

• #1 The Medical Letter Home Page | The Medical Letter, Inc.

  https://secure.medicalletter.org/TML-article-1616b

  Antibiotic treatment should be continued until clinical stability is achieved (usually within 48-72 hours) and for at least 5 days. Short courses of treatment (5-7 days) appear to be similar in efficacy to longer courses (8-10 days).12 When switching from IV to oral therapy, the same drug or a drug from the same class should be used. […] No data are available supporting the use of adjunctive corticosteroids for treatment of mild to moderate CAP. Data on whether they improve clinical outcomes in patients with severe CAP are mixed; until more evidence becomes available, they probably should not be used routinely, except in patients with CAP and refractory septic shock.13

• #1 VASF Community Acquired Pneumonia (CAP) Treatment Guidelines | Infectious Diseases Management Program at UCSF

  https://idmp.ucsf.edu/content/vasf-community-acquired-pneumonia-cap-treatment-guidelines

  VASF Community Acquired Pneumonia (CAP) Treatment Guidelines […] Outpatient Empiric CAP Treatment […] Doxycycline 100 mg PO BID (preferred) […] Amoxicillin 1 gm PO TID (alternative) […] Combination Therapy (preferred): Doxycycline 100 mg PO BID PLUS Amoxicillin 1 gm PO TID […] Suggested Duration of Therapy: Patients should be treated for a minimum of 5 days […] Most patients are treated for 5-7 days […] Inpatient Empiric CAP Treatment […] Suggested Duration of Therapy: Patients should be treated for a minimum of 5 days unless the patient has confirmed MRSA or Pseudomonas aeruginosa infection in which case the minimum duration is 7 days […] Azithromycin 500 mg PO/IV q24h x 3 doses is sufficient for atypicals; if legionella is suspected treat for 7 days […] Sputum cultures should be obtained for hospitalized patients with severe CAP or when strong risk factors for MRSA or Pseudomonas are identified […] For suspected influenza, obtain nasopharyngeal swabs for influenza antigen testing and respiratory virus DFA; if patient is hospitalized, place on droplet precautions until tests are negative, and treat with oseltamivir 75 mg PO bid for 5 days.

• #1 Pneumonia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4471-pneumonia

  Treatment for pneumonia depends on the cause bacterial, viral or fungal and how serious your case is. In many cases, the cause cant be determined and treatment is focused on managing symptoms and making sure your condition doesnt get worse. […] Some treatments may include: Antibiotics treat bacterial pneumonia. They cant treat a virus but a provider may prescribe them if you have a bacterial infection at the same time as a virus. […] Antifungal medications: Antifungals can treat pneumonia caused by a fungal infection. […] Antiviral medications: Viral pneumonia usually isnt treated with medication and can go away on its own. A provider may prescribe antivirals such as oseltamivir (Tamiflu), zanamivir (Relenza) or peramivir (Rapivab) to reduce how long youre sick and how sick you get from a virus.

• #1 Community-Acquired Pneumonia – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/pneumonia/community-acquired-pneumonia

  When usual therapy has failed, consultation with a pulmonary and/or infectious disease specialist is indicated. Antiviral therapy may be indicated for select viral pneumonias. Ribavirin is not used routinely for respiratory syncytial virus pneumonia in children or adults but may be used occasionally in high-risk children. For influenza, oseltamivir or zanamivir started within 48 hours of symptom onset and given for 5 days reduce the duration and severity of symptoms in patients who develop influenza infection. Acyclovir is recommended for children and adults with varicella lung infections. […] Though pure viral pneumonia does occur, superimposed bacterial infections are common and require antibiotics directed against S. pneumoniae, H. influenzae, and S. aureus. Follow-up x-rays are generally not recommended in patients whose pneumonia resolves clinically as expected. Resolution of radiographic abnormalities can lag behind clinical resolution by several weeks. Chest x-ray should be considered in patients with pneumonia symptoms that do not resolve or that worsen over time.

• #1 Pneumonia: Symptoms, Causes, and Treatment – Harvard Health

  https://www.health.harvard.edu/topics/pneumonia

  Pneumonia can usually be treated successfully with antibiotic, antiviral, or antifungal medications, although full recovery can take weeks. […] If a doctor suspects pneumonia, they will often prescribe antibiotics while waiting for lab tests to confirm the diagnosis. […] Further treatment will depend on the cause of the infection: Bacterial pneumonia is treated with antibiotics. The antibiotic course typically lasts anywhere from five to 14 days. Most people see improvement two to three days after starting treatment. […] Viral pneumonia may be treated with supportive care or antiviral medications if they are available. Most cases clear up within one to three weeks. […] Pneumonia caused by fungi is treated with antifungal medications. Treatment can last several months. […] In addition, over-the-counter medications are used to treat specific symptoms like cough, fever, and pain. […] Home remedies can help manage symptoms. These include: rest, drinking plenty of fluids, cold compress for fever, steam or a humidifier, not smoking, and staying away from people who do.

• #1 Pneumonia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4471-pneumonia

  Oxygen therapy: If youre not getting enough oxygen, a provider may give you extra oxygen through a tube in your nose or a mask on your face. […] IV fluids: Fluids delivered directly to your vein (IV) treat or prevent dehydration. […] Draining of fluids: If you have a lot of fluid between your lungs and chest wall (pleural effusion), a provider may drain it. This is done with a catheter or surgery. […] Viral pneumonia often goes away on its own, but you should always follow your healthcare providers recommendations to treat symptoms and reduce your risk of serious complications. […] Over-the-counter medications and other at-home treatments can help you feel better and manage the symptoms of pneumonia, including: Pain relievers and fever reducers: Your provider may recommend medicines like ibuprofen (Advil) and acetaminophen (Tylenol) to help with body aches and fever.

• #1 Pneumonia Treatment and Recovery | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/treatment-and-recovery

  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. […] 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. […] Recovery from serious lung infections, such as pneumonia, can take longer than you expect. […] While you are waiting for your body to recover, focus on taking the medications your healthcare provider has prescribed and good health practices such as lots of rest so your body can recover, fluids to keep the mucus in your lungs thin, good food so your body has energy to heal. […] If you have taken antibiotics, your doctor will want to make sure your chest X-ray is normal again after you finish the whole prescription. It may take many weeks for your X-ray to clear up.

• #1 How is pneumonia diagnosed and treated? | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/conditions/pneumonia/diagnosis

  Treatment for pneumonia depends on what type of pneumonia you have and how severe it is. […] Pneumonia can be serious so its important to get treatment quickly. The main treatment for bacterial pneumonia is antibiotics. You should also rest and drink plenty of water. […] If you have been diagnosed with pneumonia and you have chest pain, you can take painkillers such as paracetamol or ibuprofen. […] If you have mild bacterial pneumonia, you may be able to manage it at home with treatment from your GP. Your GP will prescribe antibiotics. You will most likely be given an antibiotic called amoxicillin, which is a type of penicillin. […] Its important that you finish your course of antibiotics even if you start to feel better. If you do not finish the full course, some bacteria might not be treated fully, and the pneumonia could come back. The bacteria can become resistant to the antibiotics, making it harder to treat the pneumonia.

• #1 Pneumonia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pneumonia/diagnosis-treatment/drc-20354210

  Treatment for pneumonia involves curing the infection and preventing complications. People who have community-acquired pneumonia usually can be treated at home with medication. Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more. […] Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include: […] Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don’t improve, your doctor may recommend a different antibiotic. […] Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it’s a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest. […] Fever reducers

• #1 Pneumonia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4471-pneumonia

  Cough suppressants: Check with your healthcare provider before taking cough suppressants for pneumonia. Coughing is important to help clear your lungs. […] Breathing treatments and exercises: Your provider may prescribe these treatments to help loosen mucus and help you to breathe. […] Using a humidifier: Your provider may recommend keeping a small humidifier running by your bed or taking a steamy shower or bath to make it easier to breathe. […] Drinking plenty of fluids. […] If you have bacterial pneumonia, youre no longer considered contagious when your fever is gone and youve been on antibiotics for at least two days. If you have viral pneumonia, youre still considered contagious until you feel better and have been free of fever for several days.

• #1 Pneumonia Treatment: 8 Treatment Approaches – Tua Saúde

  https://www.tuasaude.com/en/pneumonia-treatment/

  Treatment for bacterial pneumonia with antibiotics normally takes 5 to 7 days. More serious cases require hospital admission with IV medications for up to 21 days. […] In case of pneumonia, it is important to drink plenty of fluids to avoid dehydration. […] Resting is important to promote a speedy recovery. […] Oxygen therapy is typically indicated in cases where pneumonia causes symptoms such as shortness of breath or increased work of breath. […] Pneumonia can make it difficult for the lungs to function normally, and mechanical ventilation may be necessary to support the patient and ensure adequate gas exchange. […] Surgeries may be required for cases of pneumonia that lead to complications, like a pleural effusion or the accumulation of pus. […] Respiratory physiotherapy is important especially in more serious cases of pneumonia, which is associated with pulmonary sequelae and may impair breathing movements.

• #1 Overview of community-acquired pneumonia in adults – UpToDate

  https://www.uptodate.com/contents/overview-of-community-acquired-pneumonia-in-adults

  The role of adjunctive glucocorticoid treatment for CAP is evolving. […] For most immunocompetent patients with respiratory failure due to CAP who require invasive or non-invasive mechanical ventilation or with significant hypoxemia (ie, PaO2:FIO2 ratio <300 with an FiO2 requirement of ≥50 percent and use of either high flow nasal cannula or a nonrebreathing mask), we suggest continuous infusion of hydrocortisone 200 mg daily for 4 to 7 days followed by a taper. [...] Once a patient with CAP is hospitalized, further management will be dictated by the patient's response to initial empiric therapy. [...] For patients in whom a causative pathogen has been identified, we tailor therapy to target the pathogen. [...] We generally determine the duration of therapy based on the patient's clinical response to therapy.

• #1 Bacterial Pneumonia Treatment & Management: Approach Considerations, Antimicrobial Therapy for Bacterial Pneumonia, Outpatient Empiric Antibiotic Therapy

  https://emedicine.medscape.com/article/300157-treatment

  Antibiotic therapy is the mainstay of treatment of bacterial pneumonia. However, patients who have bronchospasm with infection benefit from inhaled bronchodilators, administered by means of a nebulizer metered-dose inhaler. […] Empiric therapy for the hospitalized patient should be initially broad and cover the likely causative organisms. Use caution in patients who are elderly or debilitated. If bacteremia is present in persons with pneumococcus who are older than 80 years, the mortality rate remains approximately 40%, even with aggressive treatment. […] The role of supplementing corticosteroids in patients with hypotension from septic shock remains controversial. Previously, it was recommended that septic patients who were hypotensive despite fluid resuscitation and vasopressor support be screened for occult adrenal insufficiency. However, current guidelines recommend empiric therapy with stress-dose steroids in these patients who remain hypotensive despite fluids and pressors, to avoid delay in treatment of presumed adrenal insufficiency.

• #1 Community-Acquired Pneumonia – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/pneumonia/community-acquired-pneumonia

  Treatment of Community-Acquired Pneumonia […] Risk stratification for determination of site of care […] Antibiotics […] Antivirals for influenza or varicella […] Systemic corticosteroids in selected critically ill patients […] Supportive measures. […] Risk stratification via risk prediction rules may be used to estimate mortality risk and thus help guide decisions regarding hospitalization. These rules have been used to identify patients who can be safely treated as outpatients and those who require hospitalization because of high risk of complications. However, these prediction rules should supplement, not replace, clinical judgment because many unrepresented factors, such as likelihood of adherence, ability to care for self, ability to maintain oral intake, should also influence triage decisions.

• #1 Community Acquired Pneumonia (Adult) – Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/community-acquired-pneumonia-adult-treatment/

  Community Acquired Pneumonia (Adult) – Treatment […] Recommended Treatment […] General Treatment […] Antibiotics […] Treatment length = 5 days minimum and clinically stable without fever for 48 hrs. […] Low Severity CAP (eg. CURB-65 = 0-1): […] WITH Comorbidities: […] Moderate Severity CAP (eg. CURB-65 = 2): […] High Severity CAP (eg. CURB-65 = 3-5): […] Risk of MRSA or Pseudomonas […] Aspiration Pneumonia […] Treatment length = 5-7 days if good clinical response; longer if anaerobes suspected. […] Criteria For Hospital Admission […] Discharged patients should have follow-up within 2 days. […] Criteria For Close Observation And/or Consult […] Quality Of Evidence? […] Justification […] Evidence relies on American Thoracic Society updated guidelines on CAP from 2019 as well as other sources all produced in the last few years.

• #1 Community-Acquired Pneumonia – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/pneumonia/community-acquired-pneumonia

  Intensive care unit (ICU) admission is required for patients who need mechanical ventilation or have hypotension (systolic blood pressure 90 mm Hg) that is unresponsive to volume resuscitation. Other criteria, especially if 3 are present, that should lead to consideration of ICU admission include hypotension requiring fluid support, respiratory rate 30/minute, partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FIO2) 250, multilobar pneumonia, confusion, blood urea nitrogen (BUN) 19.6 mg/dL (7 mmol/L), leukocyte count 4000 cells/microL (4 109/L), platelet count 100,000/microL (100 109/L), and temperature 36 C. […] The Pneumonia Severity Index (PSI) is the preferred validated prediction rule. However, because the PSI is complex and requires several laboratory assessments, simpler rules such as CURB-65 are a useful alternative. Use of these prediction rules has led to a reduction in unnecessary hospitalizations for patients who have milder illness.

• #1 Pneumonia | Lung inflammation – Diagnosis, Evaluation and Treatment

  https://www.radiologyinfo.org/en/info/pneumonia

  The following image-guided treatments may be used for pneumonia: […] Thoracentesis: Fluid may be taken from your chest cavity and studied to help your doctor determine which germ is causing your illness. […] Chest tube placement: During this procedure, also known as thoracostomy, a thin plastic tube is inserted into the pleural space (the area between the chest wall and lungs. […] Image-guided abscess drainage: Image-guidance helps direct placement of a needle into the abscess cavity and can aid during insertion of a drainage tube. If an abscess has formed in the lungs, it may be drained by inserting a small drainage tube (catheter). […] Each of these tests will help your doctor further evaluate your lungs and lung function or help determine the type of germ causing your pneumonia.

• #1 Pneumonia – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/lung-center/diseases-and-conditions/pneumonia

  Pneumonia is common in the United States, and many cases can be treated at home with antibiotics. […] Treatment for pneumonia requires curing the infection and preventing further complications. Your physician will create a tailored treatment plan depending on the type and severity of pneumonia, your overall health and your age. Treatment plans typically include lifestyle recommendations and medication, although hospitalization and/or surgery may be required. […] Antibiotics are commonly used to treat bacterial pneumonia. […] Hospitalization may be required for several reasons. This includes experiencing nausea and vomiting that prevent you from keeping oral antibiotics in your system, your temperature is below normal, your blood pressure drops or your heart rate is irregular. […] While most patients with pneumonia do not require surgery, it may be necessary if complications such as lung abscesses or empyema arise. Surgical interventions may include chest tubes to drain infected plural fluid.

• #1 Guidelines for the Evaluation and Treatment of Pneumonia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7112285/

  Most childhood pneumonia (CP) can be treated in the outpatient setting. […] Choosing an antibiotic for CP is initially always an empirical process and based on local and regional microbial susceptibility and resistance patterns, along with the child’s age, immunization status, and any underlying, preexisting health conditions. […] Most children can be treated with oral antibiotics in the outpatient setting. First-line and preferred agent is still amoxicillin. […] Uncomplicated pneumonia treatment in the outpatient setting usually should last 5 to 10 days. […] Inpatient admission for pneumonia warrants longer duration of antibiotic therapy, typically 7 to 10 days of combined parenteral and oral therapy or at least 1 week after becoming afebrile.

• #1 What are the treatments for pneumonia in children? | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/conditions/pneumonia/child/treatment

  If your childs pneumonia is caused by a virus then antibiotics wont work. Usually, symptom management and rest are all that are needed for treating viral pneumonia. […] Your doctor will assess if your child should be looked after in hospital based on their symptoms and other factors, including their age. Babies under six months old are more likely to be admitted to hospital. […] If your child does need to be treated in hospital, they may be given: antibiotics through a drip, fluids through a drip if theyre dehydrated, oxygen if their blood oxygen levels are low. […] It usually takes one or two weeks to recover. Viral pneumonia may take longer than this. Most children will have recovered after three or four weeks. […] The pneumococcal vaccine (PCV) is a vaccination to protect children against bacterial pneumonia caused by streptococcus pneumoniae. All babies are offered the PCV vaccine as part of their childhood vaccination programme. […] Your child should also have a yearly flu vaccination from the age of two until 11 or older. This will reduce the risk of them developing pneumonia as a complication of the flu.

• #1 Pneumonia: Symptoms, Causes, and Treatment

  https://www.webmd.com/lung/understanding-pneumonia-basics

  If your symptoms are serious or if you have other conditions that make you more likely to have complications, your doctor may send you to the hospital. While you’re there, your doctor will probably give you fluids or antibiotics through an IV. You may need oxygen therapy or breathing treatments. And the doctors might need to drain fluid from your lungs. […] Depending on what type of pneumonia you have and how sick you are, it could take anywhere from a week to a month or more to recover. You’ll probably feel fatigued for a month or so. Most people continue to feel tired for about a month. You need lots of rest while you’re recovering, so don’t try to rush it. […] You can tell you’re recovering when your symptoms improve. While you’ll probably be tired for a while, you should notice: Your fever lifts. You produce less mucus. Your chest feels better. You cough less. It’s easier to breathe.

• #1 Pneumonia Prevention and Control | Pneumonia | CDC

  https://www.cdc.gov/pneumonia/prevention/index.html

  Pneumonia can often be prevented and can usually be treated. […] Immunizations and appropriate treatment (like antibiotics and antivirals) could prevent many deaths from pneumonia each year. […] Vaccines can help prevent infection by some of the bacteria that can cause pneumonia. […] Vaccines, antibody products, or both can help prevent infection by some of the viruses that can cause pneumonia.

• #1 Bacterial Pneumonia Treatment & Management: Approach Considerations, Antimicrobial Therapy for Bacterial Pneumonia, Outpatient Empiric Antibiotic Therapy

  https://emedicine.medscape.com/article/300157-treatment

  Clinical response to antibiotic therapy should be evaluated within 48-72 hours of initiation. With appropriate antibiotic therapy, improvement in the clinical manifestations of pneumonia should be observed in 48-72 hours. […] Vaccination and other prevention guidelines are briefly discussed below.

• #1 Pneumonia in children: What you need to know | UNICEF

  https://www.unicef.org/stories/childhood-pneumonia-explained

  Oxygen is an essential and life-saving treatment for children and newborns suffering from severe pneumonia. That’s because the inflammation of their lungs prevents enough oxygen from entering their bloodstream to be circulated to the rest of the body. […] Swift action and investments are required to ensure that no child dies from pneumonia and other preventable or treatable diseases, this includes: reducing risk factors, protecting children’s immune systems and ensuring all children have access to good-quality health care, free at the point of use, with well trained and equipped health workers. […] Urgent action is needed now to end the preventable deaths caused by pneumonia. We can change the course of this disease and help keep every child alive.

• #2 Pneumonia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pneumonia/diagnosis-treatment/drc-20354210

  Treatment for pneumonia involves curing the infection and preventing complications. People who have community-acquired pneumonia usually can be treated at home with medication. Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more. […] Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include: […] Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don’t improve, your doctor may recommend a different antibiotic. […] Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it’s a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest. […] Fever reducers

• #2 Bacterial Pneumonia Treatment & Management: Approach Considerations, Antimicrobial Therapy for Bacterial Pneumonia, Outpatient Empiric Antibiotic Therapy

  https://emedicine.medscape.com/article/300157-treatment

  The goals of pharmacotherapy for bacteria pneumonia are to eradicate the infection, reduce morbidity, and prevent complications. […] Treatment of pneumonia depends largely on the empiric use of antibiotic regimens directed against potential pathogens as determined by the setting in which the infection took place and the potential for exposure to multidrug-resistant (MDR) organisms and other more virulent pathogens (ie, community-acquired pneumonia [CAP], healthcare-acquired pneumonia [HCAP], hospital-acquired pneumonia [HAP], ventilator-associated pneumonia [VAP]). […] The prevalence and resistance patterns of MDR pathogens vary between institutions and even between ICUs within the same institution. Therefore, appropriate initial antibiotic therapy for HAP and VAP may vary markedly according to hospital site. Antimicrobial prescribing practices should not necessarily be based on national guidelines, but rather on patterns of MDR organisms at individual institutions.

• #2 Updated Clinical Practice Guidelines for Community-Acquired Pneumonia

  https://www.uspharmacist.com/article/updated-clinical-practice-guidelines-for-communityacquired-pneumonia

  The guidelines recommend different treatment regimens for patients with CAP depending on the treatment location (inpatient or outpatient), whether the pneumonia is classified as severe according to the criteria in TABLE 1, and whether the patient has comorbidities or any risk factors for drug-resistant pathogens. […] Recommended empirical treatment for CAP in the outpatient setting is given in TABLE 2. For patients without comorbid conditions or risk factors for drug-resistant pathogens, monotherapy with amoxicillin, doxycycline, or a macrolide (azithromycin or clarithromycin) is recommended. […] Recommended empirical treatment for CAP in the inpatient setting is given in TABLE 3. The standard recommended empirical regimen for inpatients with nonsevere pneumonia is a beta-lactam plus a macrolide or a respiratory fluoroquinolone alone.

• #2 Bacterial Pneumonia Medication: Fluoroquinolones, Cephalosporins, Macrolides, Monobactams, Antibiotics, Lincosamide, Tetracyclines, Carbapenems, Oxazolidinones, Aminoglycosides, Penicillins, Amino, Penicillins, Extended-Spectrum, Penicillins, Natural, Sul

  https://emedicine.medscape.com/article/300157-medication

  All agents discussed in the next sections are for use in persons older than 5 years. In children younger than five years of age, initial treatment of pneumonia includes IV ampicillin or nafcillin plus gentamicin or cefotaxime (for neonates). […] The best initial antibiotic choice is thought to be a macrolide. Macrolides provide the best coverage for the most likely organisms in community-acquired bacterial pneumonia (CAP). […] Second-generation cephalosporins maintain the gram-positive activity of first-generation cephalosporins, provide good coverage against Proteus mirabilis, H influenzae, E coli, K pneumoniae, and Moraxella species, and provide adequate activity against gram-positive organisms. […] The combination of trimethoprim and sulfamethoxazole (TMP-SMZ) may be used in the patient with pneumonia and a history of chronic obstructive pulmonary disease (COPD) or smoking.

• #2 The Medical Letter Home Page | The Medical Letter, Inc.

  https://secure.medicalletter.org/TML-article-1616b

  Treatment of community-acquired pneumonia (CAP) is usually empiric, with selected antibiotic regimens directed against some of the most common causative pathogens. Recommended empiric regimens are listed in Table 2; recommended antibiotic dosages for treatment of CAP are listed in Tables 3 and 4. Joint guidelines for treatment of CAP by the American Thoracic Society and the Infectious Diseases Society of America (ATS/IDSA) were updated in 2019.1 […] For outpatient treatment of CAP in otherwise healthy adults without comorbidities (chronic heart, lung, liver or renal disease, diabetes, alcoholism, malignancy, or asplenia), current guidelines recommend oral treatment with high-dose amoxicillin (1 g tid) or doxycycline (see Table 2). […] For outpatient treatment of CAP in adults with comorbidities (chronic heart, lung, liver or renal disease, diabetes, alcoholism, malignancy, or asplenia), oral treatment with a combination of a beta-lactam (amoxicillin/clavulanate, cefpodoxime, or cefuroxime) and a macrolide (azithromycin, clarithromycin) or doxycycline is recommended.

• #2 Community-Acquired Pneumonia in Adults: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/1101/p698.html

  Outpatients with comorbidities or antibiotic use in past three months should receive a respiratory fluoroquinolone or a beta-lactam antibiotic plus a macrolide. […] Hospitalized patients who are not admitted to the ICU should receive a respiratory fluoroquinolone or a beta-lactam antibiotic and a macrolide. […] Patients with severe CAP who are admitted to the ICU should receive dual antibiotic therapy, which has been shown to improve survival. […] Meta-analyses of randomized trials of corticosteroids for CAP demonstrate a decreased risk of adult respiratory distress syndrome and modest reductions in lengths of ICU and hospital stays, duration of intravenous antibiotic treatment, and time to clinical stability without a corresponding increase in major adverse events.

• #2 Community-Acquired Pneumonia – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/pneumonia/community-acquired-pneumonia

  For children, treatment depends on age, previous vaccinations, and whether treatment is outpatient or inpatient. For children treated as outpatients, treatments are dictated by age. For children treated as inpatients, antibiotic therapy tends to be more broad-spectrum and depends on the child’s previous vaccinations. […] With empiric treatment, 90% of patients with bacterial pneumonia improve. Improvement is manifested by decreased cough and dyspnea, defervescence, relief of chest pain, and decline in white blood cell count. Failure to improve should trigger suspicion of an unusual organism, resistance to the antimicrobial used for treatment, empyema, coinfection or superinfection with a 2nd infectious agent, an obstructive endobronchial lesion, immunosuppression, metastatic focus of infection with reseeding (in the case of pneumococcal infection), nonadherence to treatment (in the case of outpatients), or wrong diagnosis (ie, a noninfectious cause of the illness such as acute hypersensitivity pneumonitis).

• #2 The Medical Letter Home Page | The Medical Letter, Inc.

  https://secure.medicalletter.org/TML-article-1616b

  Antibiotic treatment should be continued until clinical stability is achieved (usually within 48-72 hours) and for at least 5 days. Short courses of treatment (5-7 days) appear to be similar in efficacy to longer courses (8-10 days).12 When switching from IV to oral therapy, the same drug or a drug from the same class should be used. […] No data are available supporting the use of adjunctive corticosteroids for treatment of mild to moderate CAP. Data on whether they improve clinical outcomes in patients with severe CAP are mixed; until more evidence becomes available, they probably should not be used routinely, except in patients with CAP and refractory septic shock.13

• #2 Pneumonia: Diagnosis, Symptoms, and Treatment

  https://www.healthline.com/health/pneumonia

  If your symptoms are very severe or you have other health problems, you may need to be hospitalized. At the hospital, doctors can keep track of your heart rate, temperature, and breathing. Hospital treatment may include: antibiotics injected into a vein, respiratory therapy, which involves delivering specific medications directly into the lungs, or teaching you to perform breathing exercises to maximize your oxygenation, oxygen therapy to maintain oxygen levels in your bloodstream (received through a nasal tube, face mask, or ventilator, depending on severity). […] 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.

• #2 How is pneumonia diagnosed and treated? | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/conditions/pneumonia/diagnosis

  If youre too ill to drink and take tablets, you can have fluids and antibiotics through a drip in your arm. […] Most viral pneumonia goes away by itself. You should rest and drink a lot of water, and you can take painkillers if you are in pain. In some cases, your doctor will prescribe antiviral medicine. […] If you have aspiration pneumonia, you will be given antibiotics.

• #2 Community-Acquired Pneumonia – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/pneumonia/community-acquired-pneumonia

  When usual therapy has failed, consultation with a pulmonary and/or infectious disease specialist is indicated. Antiviral therapy may be indicated for select viral pneumonias. Ribavirin is not used routinely for respiratory syncytial virus pneumonia in children or adults but may be used occasionally in high-risk children. For influenza, oseltamivir or zanamivir started within 48 hours of symptom onset and given for 5 days reduce the duration and severity of symptoms in patients who develop influenza infection. Acyclovir is recommended for children and adults with varicella lung infections. […] Though pure viral pneumonia does occur, superimposed bacterial infections are common and require antibiotics directed against S. pneumoniae, H. influenzae, and S. aureus. Follow-up x-rays are generally not recommended in patients whose pneumonia resolves clinically as expected. Resolution of radiographic abnormalities can lag behind clinical resolution by several weeks. Chest x-ray should be considered in patients with pneumonia symptoms that do not resolve or that worsen over time.

• #2 Pneumonia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4471-pneumonia

  Treatment for pneumonia depends on the cause bacterial, viral or fungal and how serious your case is. In many cases, the cause cant be determined and treatment is focused on managing symptoms and making sure your condition doesnt get worse. […] Some treatments may include: Antibiotics treat bacterial pneumonia. They cant treat a virus but a provider may prescribe them if you have a bacterial infection at the same time as a virus. […] Antifungal medications: Antifungals can treat pneumonia caused by a fungal infection. […] Antiviral medications: Viral pneumonia usually isnt treated with medication and can go away on its own. A provider may prescribe antivirals such as oseltamivir (Tamiflu), zanamivir (Relenza) or peramivir (Rapivab) to reduce how long youre sick and how sick you get from a virus.

• #2 How is pneumonia diagnosed and treated? | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/conditions/pneumonia/diagnosis

  Treatment for pneumonia depends on what type of pneumonia you have and how severe it is. […] Pneumonia can be serious so its important to get treatment quickly. The main treatment for bacterial pneumonia is antibiotics. You should also rest and drink plenty of water. […] If you have been diagnosed with pneumonia and you have chest pain, you can take painkillers such as paracetamol or ibuprofen. […] If you have mild bacterial pneumonia, you may be able to manage it at home with treatment from your GP. Your GP will prescribe antibiotics. You will most likely be given an antibiotic called amoxicillin, which is a type of penicillin. […] Its important that you finish your course of antibiotics even if you start to feel better. If you do not finish the full course, some bacteria might not be treated fully, and the pneumonia could come back. The bacteria can become resistant to the antibiotics, making it harder to treat the pneumonia.

• #2 Pneumonia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4471-pneumonia

  Cough suppressants: Check with your healthcare provider before taking cough suppressants for pneumonia. Coughing is important to help clear your lungs. […] Breathing treatments and exercises: Your provider may prescribe these treatments to help loosen mucus and help you to breathe. […] Using a humidifier: Your provider may recommend keeping a small humidifier running by your bed or taking a steamy shower or bath to make it easier to breathe. […] Drinking plenty of fluids. […] If you have bacterial pneumonia, youre no longer considered contagious when your fever is gone and youve been on antibiotics for at least two days. If you have viral pneumonia, youre still considered contagious until you feel better and have been free of fever for several days.

• #2 Bacterial Pneumonia Treatment & Management: Approach Considerations, Antimicrobial Therapy for Bacterial Pneumonia, Outpatient Empiric Antibiotic Therapy

  https://emedicine.medscape.com/article/300157-treatment

  Antibiotic choices in the outpatient setting should be driven by the presence of patient risk factors, including recent exposure to antibiotics, comorbidities, and local trends in antibiotic resistance. […] For suspected infection with methicillin-resistant S aureus (MRSA), vancomycin or linezolid may be added to the antibiotic regimen until the organism’s identity and antibiotic sensitivities are known, at which point the medications can be adjusted accordingly. […] Supportive measures include the following: Analgesia and antipyretics, Chest physiotherapy, Intravenous fluids (and, conversely, diuretics) if indicated, Monitoring Pulse oximetry with or without cardiac monitoring, as indicated, Oxygen supplementation, Positioning of the patient to minimize aspiration risk, Respiratory therapy, including treatment with bronchodilators and, perhaps, N-acetylcysteine in selected patients.

• #2 Pneumonia: Recent Updates on Diagnosis and Treatment

  https://www.mdpi.com/2076-2607/13/3/522

  If risk factors for MRSA, Pseudomonas, or other Gram-negative pathogens not covered by the standard community-acquired pneumonia regimens outlined above are present, coverage should be expanded. […] Patients with severe community-acquired pneumonia who are admitted to the ICU are more likely to be at risk for resistant pathogens, including MRSA and pseudomonas. […] With the alarming global rise in multidrug-resistant Gram-negative Bacilli, antibiotic therapy for treating patients with pneumonia can be challenging and must be guided by in vitro susceptibility results. […] Several of the prominent antibiotics that have been approved for complicated pneumonias are listed in Table 2. […] The use of glucocorticoids in the treatment of other causes of community-acquired pneumonia is evolving.

• #2 Community-Acquired Pneumonia – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/pneumonia/community-acquired-pneumonia

  Intensive care unit (ICU) admission is required for patients who need mechanical ventilation or have hypotension (systolic blood pressure 90 mm Hg) that is unresponsive to volume resuscitation. Other criteria, especially if 3 are present, that should lead to consideration of ICU admission include hypotension requiring fluid support, respiratory rate 30/minute, partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FIO2) 250, multilobar pneumonia, confusion, blood urea nitrogen (BUN) 19.6 mg/dL (7 mmol/L), leukocyte count 4000 cells/microL (4 109/L), platelet count 100,000/microL (100 109/L), and temperature 36 C. […] The Pneumonia Severity Index (PSI) is the preferred validated prediction rule. However, because the PSI is complex and requires several laboratory assessments, simpler rules such as CURB-65 are a useful alternative. Use of these prediction rules has led to a reduction in unnecessary hospitalizations for patients who have milder illness.

• #2 Pneumonia – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/lung-center/diseases-and-conditions/pneumonia

  Pneumonia is common in the United States, and many cases can be treated at home with antibiotics. […] Treatment for pneumonia requires curing the infection and preventing further complications. Your physician will create a tailored treatment plan depending on the type and severity of pneumonia, your overall health and your age. Treatment plans typically include lifestyle recommendations and medication, although hospitalization and/or surgery may be required. […] Antibiotics are commonly used to treat bacterial pneumonia. […] Hospitalization may be required for several reasons. This includes experiencing nausea and vomiting that prevent you from keeping oral antibiotics in your system, your temperature is below normal, your blood pressure drops or your heart rate is irregular. […] While most patients with pneumonia do not require surgery, it may be necessary if complications such as lung abscesses or empyema arise. Surgical interventions may include chest tubes to drain infected plural fluid.

• #2 What are the treatments for pneumonia in children? | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/conditions/pneumonia/child/treatment

  The treatment for pneumonia will depend on whether doctors think it is caused by bacteria or a virus. Many children can be cared for at home, but some may need to be treated in hospital. […] Your child will be given antibiotics to treat their pneumonia if doctors suspect its caused by bacteria. Its not always easy to tell if pneumonia is caused by bacteria or a virus. Sometimes doctors may decide to give antibiotics if they cant be sure of the cause. […] If its likely that your child has bacterial pneumonia, they will be given antibiotics in liquid or tablet form to fight the bacteria. Your childs symptoms will usually improve within the first 48 hours – but theyll probably continue to cough for longer. […] Its important to finish the whole course of antibiotics, even if your child seems better. If they dont finish the whole course, the bacteria may not have been treated fully. This means that bacteria can become resistant to the antibiotics, making it harder to treat the pneumonia.

• #2 Bacterial Pneumonia Treatment & Management: Approach Considerations, Antimicrobial Therapy for Bacterial Pneumonia, Outpatient Empiric Antibiotic Therapy

  https://emedicine.medscape.com/article/300157-treatment

  Clinical response to antibiotic therapy should be evaluated within 48-72 hours of initiation. With appropriate antibiotic therapy, improvement in the clinical manifestations of pneumonia should be observed in 48-72 hours. […] Vaccination and other prevention guidelines are briefly discussed below.

• #2 Overview of community-acquired pneumonia in adults – UpToDate

  https://www.uptodate.com/contents/overview-of-community-acquired-pneumonia-in-adults

  The role of adjunctive glucocorticoid treatment for CAP is evolving. […] For most immunocompetent patients with respiratory failure due to CAP who require invasive or non-invasive mechanical ventilation or with significant hypoxemia (ie, PaO2:FIO2 ratio <300 with an FiO2 requirement of ≥50 percent and use of either high flow nasal cannula or a nonrebreathing mask), we suggest continuous infusion of hydrocortisone 200 mg daily for 4 to 7 days followed by a taper. [...] Once a patient with CAP is hospitalized, further management will be dictated by the patient's response to initial empiric therapy. [...] For patients in whom a causative pathogen has been identified, we tailor therapy to target the pathogen. [...] We generally determine the duration of therapy based on the patient's clinical response to therapy.

• #3 How can I manage the symptoms of pneumonia?

  https://www.icliniq.com/qa/pneumonia/what-is-the-treatment-of-pneumonia

  Given the symptoms, it is understandable to be concerned about pneumonia. Pneumonia is a serious lung infection that requires prompt medical attention. Your symptoms, especially the worsening shortness of breath and chest pain, could indicate that the infection is affecting your lung function and could be pneumonia or another respiratory condition. […] To confirm the diagnosis, you may need to do a chest X-ray. Also plan for CBC (complete blood count, a test that measures various components of the blood), O2 levels (measurement of oxygen saturation in the blood), and sputum test (a test to analyze mucus from the lungs). If pneumonia is diagnosed, the treatment will depend on its cause. Bacterial pneumonia is typically treated with antibiotics, which should be started promptly to reduce the risk of complications. If the pneumonia is viral, antiviral medications may be prescribed, although the mainstay of treatment for viral pneumonia often involves supportive care, such as rest, fluids, and over-the-counter medications to manage fever and pain. In severe cases, especially if breathing becomes increasingly difficult, hospitalization might be necessary for oxygen therapy or even mechanical ventilation. […] Plan for hospitalization if anything gets serious. Early diagnosis and appropriate treatment are key to managing pneumonia effectively and preventing further health issues.

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