Pneumonia Health Article

Treatment

Prior to the discovery of penicillin and other antibiotics, bacterial pneumonia was almost always fatal. In the early 2000s, especially given early in the course of the disease, antibiotics are very effective against bacterial causes of pneumonia. Penicillin was, as of 2004, still the first choice for treating children with pneumonia unless the child is known to be penicillin-resistant. Oral amoxicillin or cephalosporins are often administered first in treating milder cases of pneumococcal pneumonia in children younger than age five, though they are not used in newborns. Erythromycin and tetracycline are broad-spectrum antibiotics that are known to improve recovery time for symptoms of mycoplasma pneumonia. They do not, however, eradicate the organisms. If the results of culture and sensitivity positively identify the causative bacteria, an antibiotic is prescribed for that demonstrated sensitivity. Viruses do not usually respond to antibiotics. Amantadine and acyclovir may be helpful against certain viral pneumonias.

Linezolid (Zyvox), the first of a new line of antibiotics known as oxazolidinones, is used to treat penicillin-resistant organisms that cause pneumonia. Another newer drug known as ertapenem (Invanz) is reported to be effective in treating bacterial pneumonia.

The child is also be given fluids and possibly drug therapy to thin mucus secretions (mucolytic agents) or medication to open the airways of the lung (brochodilators). Cough suppressants may be given as well as pain medication and fever-reducing medication. Hospitalized children may receive extra oxygen, respiratory therapy, and intravenous antibiotics and fluids.

Alternative treatment

Vitamin C is known to improve immune response and to help reduce inflammation. Grape seed extract enhances immune system functioning and helps protect lung tissue. These are adjunctive measures that do not destroy the causative organism as antibiotics do. Although garlic and certain herbs such as yerba mansa may have antibiotic properties, they cannot replace specific antibiotics used to treat pneumonia.

Prognosis

Prognosis varies according to the type of organism causing the infection, the status of the immune system, and the overall health of the affected child. Generally, there are lower mortality rates from pneumonia in the United States than elsewhere in the world. Streptococcus pneumoniae, the most common organism causing pneumonia, has a significantly lower death rate of about 5 percent. More complications occur in the very young or very old with multiple areas of the lung infected simultaneously. The presence of chronic illnesses such as diabetes, cirrhosis, and congestive heart failure may increase the chance of complications. Individuals with immunodeficiency disorders, various types of cancer, or AIDS are also more prone to complications. In children, cystic fibrosis, aspiration problems, immunodeficiencies, and congenital or acquired lung malformation may increase the risk of pneumonia from S. pneumoniae.

Recovery following pneumonia with Mycoplasma pneumoniae is nearly 100 percent. However, in the very young or very old or immunodeficient, Staphylococcus aureus has a death rate of 30 to 40 percent. Similarly, infections with a number of gram negative bacteria (such as those in the gastrointestinal tract that can cause infection following aspiration) have a death rate of 25 to 50 percent.