Hospital therapy. Treatment of pneumonia (most important)

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Hospital therapy. Treatment of pneumonia (most important)

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33. Treatment of pneumonia

Treatment. Immediately after the diagnosis is made, it is necessary to start etiotropic therapy of pneumonia. Of great importance are empirical ideas about a possible pathogen, since bacteriological examination of sputum has been carried out for quite a long time and in most patients, even with a modern approach to this study, it gives uncertain and sometimes erroneous results.

At the moment, penicillins have lost their importance as the drug of choice in the treatment of pneumonia.

In connection with the foregoing, in the treatment of pneumonia, much attention is paid to macrolides, which have proven effective not only against pneumococcus, but also against Mycoplasma pneumoniae, Chlamydia pneumoniae.

Dosing of antibiotics used in the treatment of pneumonia.

1. Penicillins: benzylpenicillin (500-000 units intravenously every 1-000 hours or 000-6 units intramuscularly every 8 hours), ampicillin (500-000-1 g intramuscularly every 000-000 hours or 4 g every 0,5 hours intravenously), amoxicillin (1,0-2,0 g every 6 hours orally or 8-0,5 g every 6-0,5 hours intramuscularly, intravenously), oxacillin ( 1,0 g every 8-0,5 hours orally, intramuscularly, intravenously).

2. Cephalosporins: I generation - cephalothin (keflin) (0,5-2,0 g every 4-6 hours intramuscularly, intravenously), cefazolin (kefzol) (0,5-2,0 g, every 8 hours intramuscularly, intravenously ), II generation - cefuroxime (zinacef, ketocef) (0,75-1,5 g every 6-8 hours intramuscularly, intravenously), III generation - cefotaxime (claforan) (1,0-2,0 g, maximum up to 12 g / day every 12 hours intramuscularly, intravenously), ceftriaxone (longacef, rocefin) (1,0-2,0-4,0 g every 24 hours intramuscularly, intravenously).

3. Aminoglycosides: Genetamycin (80 mg every 12 hours IM, IV), Amikacin (10-15 mg/kg every 12 hours IM, IV), Tobramycin (Brulamycin) (3-5 mg/kg every 8 hours IM, IV) .

4. Macrolides: erythromycin (0,5 g every 6-8 hours orally or 0,5-1,0 g every 6-8 hours intravenously), rovamycin (3,0 million IU every 8-12 hours orally or 1,5. 3,0-8 million IU every 12-XNUMX hours IV).

5. Fluoroquinolones: pefloxacin (leflacin) (400 mg every 12 hours orally, IV), ciprofloxacin (cyprobay) (500 mg every 12 hours orally or 200-400 mg every 12 hours intravenously), ofloxacin (zanocin, tarivid) (200 mg every 12 hours orally).

6. Tetracyclines: doxycycline (vibramycin) (200 mg on day 1, on subsequent days - 100 mg every 24 hours orally), minocycline (minocin) (200 mg on day 1, on subsequent days - 100 mg every 12 hours orally), aztreonam (azactam) (1,0-2,0 g every 8-12 hours), imipenem/cilstatin (thienam) (500 mg every 6-8 hours intramuscularly).

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