Week 4 Discussion Pneumonia Pneumonia is classified as a lower respiratory tract infection that causes morbidity and mortality across the globe with children, elderly, and immunocompromised patients being the most susceptible. Viruses, bacteria, mycobacteria, mycoplasma, and fungi are pathogens that cause pneumonia, and the most common bacteria is Streptococcus pneumoniae (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Other pathogens responsible for pneumonia infections are H. Influenzae, S. aureus, gram-negative bacilli, and to a lesser extent M. catarrhalis , Streptococcus pyogenes , Chlamydia psittaci , and Neisseria meningitidis (Arcangelo et al., 2017). Inflammation of the lung parenchyma occurs with pneumonia and presents with signs and symptoms of fever, chills, shortness of breath, purulent sputum, and chest pain (Arcangelo et al., 2017). Fever, tachycardia, decreased breath sounds, and crackles can be observed with examination (Arcangelo et al., 2017). Diagnosis of pneumonia is based off of clinical criteria and chest x-rays. Sputum samples can also be analyzed; however, it is often difficult to isolate the causative pathogen because either sputum is not produced, or poor samples are obtained (Arcangelo et al., 2017). White cell counts, C-reactive protein (CRP), erythrocyte sedimentation rate, and procalcitonin can also be obtained, but again do not determine the pathogen responsible or if it is viral or bacterial (Boyd, 2017).
Medications to Treat Pneumonia Selecting the appropriate therapy is key to destroying the pathogen responsible for producing pneumonia. The severity of the pneumonia will determine what medications to begin. In a normally healthy adult individuals, a macrolide such as azithromycin or clarithromycin or doxycycline, which is a tetracycline are first-line medications (Arcangelo et al., 2017). When the causative agent is unknown, the best course of action is to begin the patient on empirical antibiotic therapy (Adis Medical Writers, 2017). If a patient has comorbidities or requires hospitalization, treatment with aminopenicillin with a B-lactamase inhibitor, such as amoxicillin- clavulanate, plus a macrolide like azithromycin is recommended (Adis Medical Writers, 2017). Fluoroquinolone, such as levofloxacin can also be used as a monotherapy but is not preferred since it does not cover atypical pathogens (Adis Medical Writers, 2017). Patients with Pseudomonas infections should be treated using a B-lactam with both an antipneumococcal and antipseudomonal efficacy, such as piperacillin-tazobactam, plus a fluoroquinolone like ciprofloxacin (Adis Medical Writers, 2017). Pneumonia involving methicillin-resistant S. aureus
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