From the Guidelines
Bacterial pneumonia is a lung infection caused by bacteria, most commonly Streptococcus pneumoniae, and its treatment typically involves antibiotics, with the choice of antibiotic depending on the severity of the disease and the presence of risk factors. The causes of community-acquired pneumonia (CAP) include a variety of bacteria, with Streptococcus pneumoniae being the most common cause, followed by other bacteria such as Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydophila pneumoniae 1. Symptoms of bacterial pneumonia include fever, cough with purulent sputum, chest pain, difficulty breathing, and fatigue, and can be diagnosed based on clinical symptoms and signs, such as cough, dyspnea, pleural pain, sweating/fevers/shivers, aches and pains, temperature 38C or greater, tachypnea and new and localizing chest examination signs 1. The treatment of bacterial pneumonia typically involves antibiotics, with amoxicillin being the first-line choice for outpatient treatment of mild to moderate cases, and a respiratory fluoroquinolone or a combination of a beta-lactam plus a macrolide being used for more severe cases or patients with risk factors 1. Some key points to consider in the treatment of bacterial pneumonia include:
- The choice of antibiotic should be based on the severity of the disease and the presence of risk factors, such as advanced age, smoking, chronic diseases, and immunosuppression 1.
- The duration of antibiotic treatment should be 7-10 days for classical bacterial infection or uncomplicated CAP, and 10-14 days for suspected or proven atypical bacterial infection 1.
- Hospitalization is necessary for severe cases, with intravenous antibiotics being used, and supportive care includes adequate hydration, rest, fever control, and oxygen therapy if needed 1.
- The use of antibiotics should be guided by local susceptibility patterns and the prediction of the most likely pathogen(s) 1.
From the FDA Drug Label
Community-acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy. Azithromycin should not be used in patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate to severe illness or risk factors such as any of the following: patients with cystic fibrosis, patients with nosocomially acquired infections, patients with known or suspected bacteremia, patients requiring hospitalization, elderly or debilitated patients, or patients with significant underlying health problems that may compromise their ability to respond to their illness (including immunodeficiency or functional asplenia).
The causes of community-acquired pneumonia (CAP) caused by bacteria include:
- Chlamydophila pneumoniae
- Haemophilus influenzae
- Mycoplasma pneumoniae
- Streptococcus pneumoniae
The symptoms of CAP are not directly stated in the provided drug labels. However, it can be inferred that patients with moderate to severe illness or certain risk factors may exhibit more severe symptoms, which may include:
- Cystic fibrosis
- Nosocomially acquired infections
- Known or suspected bacteremia
- Requirement for hospitalization
- Significant underlying health problems
- Immunodeficiency or functional asplenia 2 2
From the Research
Causes of Community-Acquired Pneumonia (CAP)
- Bacterial infection is a common cause of CAP, with Streptococcus pneumoniae being one of the most frequent pathogens 3
- Other bacteria that can cause CAP include Mycoplasma, Chlamydia, and Legionella species 4
Symptoms of CAP
- Symptoms of CAP can include cough, fever, shortness of breath, and chest pain 4
- The severity of symptoms can vary depending on the causative pathogen and the patient's underlying health status 5, 6
Diagnosis of CAP
- Diagnosis of CAP is based on history, physical examination, and chest x-ray 4
- Diagnostic studies such as sputum Gram's stain and culture, blood cultures, and urinary antigen test for Legionella pneumophila may also be used 4
Treatment of CAP
- Appropriate antibiotic treatment can reduce the duration of symptoms, risk of complications, and mortality 3
- Treatment options for CAP include monotherapy with a fluoroquinolone such as levofloxacin, or combination therapy with a beta-lactam antibiotic such as ceftriaxone and a macrolide such as azithromycin 5, 6, 7
- The choice of antibiotic therapy should be based on the severity of the disease, the patient's underlying health status, and the likelihood of resistance to certain antibiotics 3, 4