Evaluation and planning of appropriate treatment, principally antibiotics, for inflammation of the air sacs of the lungs caused by infection.
Indication
- High fever, chills, productive cough, and shortness of breath
- Diagnosis of community-acquired pneumonia (CAP)
- Hospital-acquired and ventilator-associated pneumonia
- Suspected aspiration pneumonia
- Opportunistic infections in immunocompromised patients
- Patients with a moderate-to-high CURB-65 score warranting hospital admission
Preparation
- Detailed history, physical examination, and oxygen saturation measurement
- Chest X-ray or, if needed, thoracic computed tomography
- Complete blood count, CRP, procalcitonin, kidney and liver function tests, and sputum analysis
- Blood and sputum cultures for hospitalized cases, and arterial blood gas if needed
How it's performed
- Disease severity is graded using the CURB-65 score (confusion, urea, respiratory rate, blood pressure, age)
- Outpatient oral antibiotics for mild cases (e.g., amoxicillin/clavulanate or a macrolide)
- Hospital admission, intravenous antibiotics, and oxygen therapy for moderate-to-severe cases
- Fluid balance is maintained and antipyretics or, if needed, expectorant support is provided
- In hospital-acquired pneumonia, broad-spectrum antibiotics are de-escalated based on culture results
- Non-invasive or mechanical ventilation is considered in patients who develop respiratory failure
Post-procedure
- Clinical response and fever are monitored during the first 48-72 hours of treatment
- Follow-up chest imaging is recommended after 4-6 weeks
- Smoking cessation support and pneumococcal/influenza vaccination are planned for at-risk groups
- Aspiration-prevention measures for patients with swallowing difficulties
- Re-evaluation of underlying conditions (COPD, heart failure) when present
Risks
- Respiratory failure and sepsis if treatment is inadequate
- Development of pleural effusion and empyema
- Allergy and diarrhea due to antibiotics (including Clostridioides difficile)
- Dehydration and confusion (delirium) in older adults
- Recurrence and, rarely, lung abscess
FAQ
Is pneumonia contagious?
Some bacterial and viral forms of pneumonia can be transmitted by respiratory droplets; masks, hand hygiene, and ventilation reduce the risk.
Will I need to be admitted to the hospital?
Decisions are based on parameters such as age, comorbidities, and the CURB-65 score; mild cases are usually treated as outpatients.
How many days are antibiotics used?
Five to seven days may be sufficient for typical community-acquired pneumonia; the duration may be longer in severe or resistant cases.
Is it possible to prevent pneumonia with vaccines?
Pneumococcal and influenza vaccines significantly reduce the risk of pneumonia, particularly in adults over 65 and those with chronic illnesses.
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