More Things One Should Know about Pneumonia
Allow me to discuss one of the most common pulmonary diseases–pneumonia.
Pneumonia is an infection that inflames your lungs, making your lungs less effective in removing carbon dioxide and taking in oxygen from the air.
The symptoms of pneumonia include cough, fever, chills, purulent sputum and dyspnea (shortness of breath).
The causative agent of pneumonia can be bacteria, fungus and virus.
Pneumonia is not caused by sweat that dried up in your back.
Pneumonia is the sixth leading cause of death in the world.
There are three different types of pneumonia based on severity.
1. Community acquired pneumonia- low risk (CAP-LR) is defined as having infection in the lungs but the vital signs remain stable. It has a mortality rate of 1 to 3%.
CAP-LR can be managed at home with antibiotic like amoxicillin. Higher antibiotic with broader spectrum coverage like cefuroxime or co-amoxiclav is required if the patient has co-morbidity.
2. Community acquired pneumonia-moderate risk (CAP-MR) is defined as lung infection associated with slight abnormality of vital signs, such as elevated heart rate and respiratory rate.
Any pneumonia associated with water in the lungs and acute decompensation of co-morbidity is also considered as CAP-MR.
A patient with CAP-MR should be managed in a hospital since it has higher mortality rate at 8 to 10%.
The recommended treatment includes double antibiotic coverage like ceftriaxone plus azithromycin.
A double antibiotic coverage is recommended to ensure that all possible organism causing the pneumonia is covered.
3. Community acquired pneumonia-high risk (CAP-HR) is defined as severe infection of the lungs leading to drop in blood pressure and unstable vital signs
A patient with CAP-HR should be managed at the hospital’s intensive care unit (ICU), because it carries high mortality rate of up to 30%
Most CAP-HR patients require mechanical ventilation in order to survive.
Just like CAP-MR, double antibiotic coverage is also recommended for CAP-HR. But the antibiotic to be used for CAP-HR should be higher than that for CAP-MR.
Meropenemplus levofloxacin is an example of antibiotic combination used for CAP-HR.