From the Guidelines
Walking pneumonia, also known as atypical pneumonia, is typically treated with antibiotics, with the most common treatment being a macrolide antibiotic such as azithromycin (500mg on day 1, then 250mg daily for 4 more days) or clarithromycin (500mg twice daily for 7-14 days), as recommended by the most recent guidelines 1. The choice of antibiotic is crucial in treating atypical pneumonia, and the guidelines suggest that macrolides, such as azithromycin or clarithromycin, are the preferred treatment options.
- Azithromycin is a commonly used macrolide antibiotic, with a dosage of 500mg on day 1, followed by 250mg daily for 4 more days.
- Clarithromycin is another option, with a dosage of 500mg twice daily for 7-14 days. For patients allergic to macrolides, alternative treatment options include:
- Doxycycline (100mg twice daily for 7-14 days)
- A fluoroquinolone like levofloxacin (750mg once daily for 5 days) It's essential to note that the treatment of atypical pneumonia should be guided by the most recent and highest-quality evidence, and the choice of antibiotic should be based on the patient's specific needs and medical history, as well as the potential for antibiotic resistance, as reported in some areas, especially in Asia 1. Additionally, rest, hydration, and over-the-counter medications like acetaminophen or ibuprofen can help manage symptoms and support recovery.
- Rest is essential during recovery to help the body fight off the infection.
- Staying well-hydrated helps loosen mucus in the lungs and supports overall health.
- Over-the-counter medications like acetaminophen or ibuprofen can help manage fever and discomfort. It's crucial to complete the full course of antibiotics, even if symptoms improve before finishing, to ensure that the infection is fully cleared and to reduce the risk of antibiotic resistance.
- Completing the full course of antibiotics is essential to prevent the development of antibiotic-resistant bacteria.
- Stopping antibiotics too soon can lead to incomplete treatment and increased risk of complications.
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 The recommended dose of azithromycin for oral suspension for the treatment of pediatric patients with community-acquired pneumonia is 10 mg/kg as a single dose on the first day followed by 5 mg/kg on Days 2 through 5 Adults: 500 mg as a single dose on Day 1, followed by 250 mg once daily on Days 2 through 5
The treatment for atypical pneumonia (walking pneumonia) is azithromycin.
- For adults, the recommended dose is 500 mg as a single dose on Day 1, followed by 250 mg once daily on Days 2 through 5.
- For pediatric patients, the recommended dose is 10 mg/kg as a single dose on the first day followed by 5 mg/kg on Days 2 through 5. 2 2
From the Research
Treatment Options for Atypical Pneumonia
The treatment for atypical pneumonia, also known as walking pneumonia, typically involves the use of antibiotics. The following are some of the treatment options:
- Azithromycin: A 1.5 g total dose of azithromycin has been shown to be effective in treating atypical pneumonia, with a three-day or five-day regimen being equally effective 3.
- Macrolides: Macrolides, such as azithromycin and clarithromycin, have been shown to be effective in treating atypical pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella spp. 4.
- Fluoroquinolones: Fluoroquinolones, such as gemifloxacin or moxifloxacin, have also been shown to be effective in treating atypical pneumonia 4.
- Doxycycline: Doxycycline is another antibiotic that has been shown to be effective in treating atypical pneumonia 4.
- Roxithromycin: A 10-day course of roxithromycin has been compared to a 3-day course of azithromycin, with similar efficacy and safety profiles 5.
- Erythromycin: Erythromycin has been compared to azithromycin, with similar efficacy but more side effects 6.
Recommended Treatment Approach
The recommended treatment approach for atypical pneumonia includes:
- Prompt serological diagnosis
- Aggressive supportive care
- Presumptive antibiotics, especially in patients with poor prognosis 7. It is essential to note that the treatment approach may vary depending on the causative pathogen and the patient's clinical presentation.