Pneumonia - Treatment

(Page 3)

Hospitalization Guidelines

Treatment. If the pneumonia is severe enough for hospitalization, the standard treatment is intravenous antibiotics for 5 - 8 days. In cases of uncomplicated pneumonia, many patients may need only 2 or 3 days of intravenous antibiotics followed by oral therapy. Antibiotics taken by mouth are prescribed when the patient has improved substantially or leaves the hospital.

ITSA/ATS guidelines recommend that patients admitted to the hospital (but not the ICU) be treated with fluoroquinolones or a beta-lactam plus a macrolide (preferably cefotaxime or ceftriaxone and ampicillin).

---

---

Duration of Stay. Patients should remain in the hospital until all their vital signs are stable. Most patients become stabilized in 3 days and can continue treatment at home. Many experts use seven variables to measure stability and to determine whether the patient can go home:

• Temperature. Some experts believe that patients can go home when their temperature drops to 101 °F. Stricter criteria require that it be at or close to 98.6 °F.
• Respiration rate. Goal is a normal breathing rate, although expert opinion differs on the degree of normality required for discharge.
• Heart rate. Goal is 100 beats per minute or less.
• Blood pressure. Goal is systolic blood pressure of 90 mmHg or greater.
• Oxygenation. Goal is determined by the physician.
• The ability to eat. Goal is regular appetite.
• Mental function. Goal is normal.

Patients or their families should discuss these criteria with their doctor.

Chest Therapy

Chest therapy using incentive spirometry, rhythmic inhalation and coughing, and chest tapping are all important techniques to loosen the mucus and move it out of the lungs. It should be used both in the hospital and during recovery at home.

Incentive Spirometry. The patient uses an incentive spirometer at regular intervals to improve breathing and loosen sputum. The spirometer is a hand-held clear plastic device that includes a breathing tube and a container with a movable gauge. The patient exhales and then inhales forcefully through the tube, using the pressure of the inhalation to raise the gauge to the highest level possible.