From the Guidelines
The treatment for pneumococcal pneumonia is typically with antibiotics, such as amoxicillin, cefotaxime, or ceftriaxone, depending on the severity of the disease and the patient's susceptibility to the pathogen.
Key Considerations
- The choice of antibiotic depends on the severity of the disease, the patient's age, and the presence of any underlying medical conditions 1, 2.
- For outpatient treatment, amoxicillin is often the preferred choice for susceptible strains of Streptococcus pneumoniae, while macrolides or doxycycline may be used for patients with recent antibiotic therapy or comorbidities 3.
- For inpatient treatment, a combination of a β-lactam and a macrolide or a respiratory fluoroquinolone may be used, depending on the severity of the disease and the patient's risk factors 2, 3.
Antibiotic Options
- Amoxicillin: 80-100 mg/kg/day in three daily intakes for children weighing less than 30 kg, or 500-1000 mg every 8 hours for adults 4.
- Cefotaxime: 1-2 grams every 8-12 hours for adults, depending on the severity of the disease and the patient's renal function 2.
- Ceftriaxone: 1-2 grams every 24 hours for adults, depending on the severity of the disease and the patient's renal function 2.
- Macrolides: such as azithromycin or clarithromycin, may be used for outpatient treatment, especially for patients with recent antibiotic therapy or comorbidities 3.
Duration of Treatment
- The duration of treatment for pneumococcal pneumonia is typically 10-14 days, depending on the severity of the disease and the patient's response to treatment 4, 2.
- Treatment should be continued until the patient has been afebrile for at least 24-48 hours and has shown significant clinical improvement 4, 2.
From the Research
Treatment Options for Pneumococcal Pneumonia
- The treatment for pneumococcal pneumonia includes the use of antibiotics such as macrolides, beta-lactams, and quinolones 5.
- Penicillin G is also a recommended treatment option, with a continuous infusion of 20-24 million units per day providing effective serum levels against most penicillin-resistant Streptococcus pneumoniae (PRSP) strains 6.
- In cases of severe infections, such as bacterial meningitis, the addition of vancomycin to a third-generation cephalosporin is advisable while awaiting laboratory test results 7.
- For empiric therapy of bacteraemic pneumococcal pneumonia, the combination of beta-lactams and macrolides is recommended 8.
- Adjunctive therapies, such as corticosteroids and cyclic adenosine monophosphate-elevating agents, may also be useful in decreasing mortality 9.
Antibiotic Resistance and Treatment
- The emergence of antibiotic-resistant Streptococcus pneumoniae strains is a concern, with resistance affecting various classes of drugs, including beta-lactams, macrolides, and fluoroquinolones 9, 7.
- New alternative molecules, such as fluoroquinolones, streptogramins, and oxazolidinones, have shown efficacy against penicillin-resistant pneumococci 7.
- The use of polysaccharide or conjugated vaccines is highly recommended to prevent pneumococcal infections 7, 8.